低氘水对^(131)I治疗甲状腺癌致辐射性胃肠炎的疗效评价

Evaluation of the therapeutic effect of deuterium depleted water on gastroenteritis induced by^(131)I radiation in thyroid cancer treatment

目的探讨口服低氘水对^(131)I治疗甲状腺癌致辐射性胃肠炎的疗效。方法连续收集2022年5月—2023年2月于常熟市第二人民医院核医学科采用^(131)I治疗的甲状腺乳头状癌(下简称甲状腺癌)患者50例,将其分为对照组和实验组,每组25例。对照组予以口服奥美拉唑肠溶胶囊,同时予口服纯净水660 mL tid,连续5 d;实验组在同对照组用药的基础上予口服低氘水660 mL tid,连续5 d。采用Fisher`s精确检验及Kaplan-Meier分析,观察比较2组患者服^(131)I后辐射性胃肠炎发生情况,及胃肠道临床症状的缓解情况。结果服^(131)I后第1天至第5天,实验组患者发生胃肠道炎症例数分别为2(8%),5(20%),2(8%),1(4%),0(0%);对照组为2(8%),8(32%),4(16%),3(12%),1(4%)。2组间胃肠道炎发生率比较差异具有统计学意义(χ^(2)=4.064,P=0.044)。治疗5 d后,实验组患者总有效率96%,高于对照组的76%,2组间差异有统计学意义(χ^(2)=9.105,P=0.025)。结论口服低氘水对^(131)I治疗甲状腺癌致辐射性胃肠道炎临床症状的缓解具有一定的疗效。建议临床进一步探讨应用。

Objective To investigate the therapeutic effect of oral administration of deuterium depleted water on gastroenteritis induced by^(131)I radiation in thyroid cancer treatment.Methods Fifty patients with papillary thyroid cancer treated with^(131)I in the Department of Nuclear Medicine of Changshu No.2 People’s Hospital from May 2022 to February 2023 were divided into control group and experimental group(25 patients in each group).Data were continuously collected throughout the study duration.The control group was orally administrated omeprazole enteric-coated capsules and purified water at 660 mL tid for 5 days.The experimental group received the same basic treatment as the control group except that deuterium depleted water was used instead of purified water.The incidence and alleviation of^(131)I radiation-induced gastroenteritis were observed and compared between the two groups using the Fisher’s exact test and Kaplan-Meier analysis.Results The number of gastroenteritis cases from day 1 to day 5 after^(131)I administration was 2(8%),5(20%),2(8%),1(4%),and 0(0%),respectively,in the experimental group,and 2(8%),8(32%),4(16%),3(12%),and 1(4%),respectively,in the control group.The incidence of gastroenteritis was significantly different between the two groups(χ^(2)=4.064,P=0.044).After 5 days of treatment,the overall response rate of patients in the experimental group was 96%,which was significantly higher than 76%in the control group(χ^(2)=9.105,P=0.025).Conclusion Oral administration of deuterium depleted water is effective in the relief of clinical symptoms of^(131)I radiation-induced gastroenteritis in thyroid cancer treatment.The clinical application of deuterium depleted water should be further investigated.