不同剂量131I治疗中低危分化型甲状腺癌的疗效比较

Comparison of Therapeutic Effects of 131I with Different Doses in the Treatment of Low-Risk Differentiated Thyroid Carcinoma

目的比较不同剂量131-I治疗中低危分化型甲状腺癌(DTC)的临床效果。方法选取2014年1月—2018年1月四川省攀枝花市中心医院收治的90例中低危DTC者,并将其随机分为低剂量组(131-I剂量为1.1Bq)、高剂量组(131-I剂量为3.7Bq)组,各45例。分别比较两组患者在6个月后患者的促甲状腺激素(TSH)水平、甲状腺球蛋白(Tg)、术后的残余组织的残留与清除情况(简称清甲)和治疗反应情况。结果两组患者在治疗后6周、6个月的TSH、Tg值较治疗前均有下降(P<0.05);在治疗后6周、6个月高剂量组的TSH、Tg值均低于低剂量组(P<0.05);在6个月的治疗结束后,高剂量组的清甲成功率、治疗反应中的良好率高于低剂量组(P<0.05),不确定率低于低剂量组(P<0.05),但整个治疗期间,低剂量患者出现的呼吸困难的不良反应比高剂量组更少(P<0.05),组间其他数据比较差异无统计学意义(P>0.05)。结论在治疗中、低危DTC的术后清甲的效果上,高剂量的131-I强于低剂量的131-I,治疗反应也更好。

Objective To compare the clinical effects of different doses of 131-I in the treatment of low-and low-risk differentiated thyroid carcinoma(DTC).Methods From January 2014 to January 2018,90 patients with moderate or low risk DTC were randomly divided into low dose group(131-I dose of 1.1 Bq)and high dose group(131-I dose of 3.7 Bq),45 cases in each group.The levels of thyroid stimulating hormone(TSH),residual tissue clearance after thyroglobulin(Tg)and therapeutic response were compared between the two groups after 6 months.Results The TSH,Tg values of 45 patients in each group after treatment were lower than those before treatment at 6 weeks and 6 months(P<0.05),and the TSH,Tg value of high dose group at 6 weeks after treatment was lower than those of low dose group(P<0.05).After 6 months of treatment,the success rate of nail removal in the high-dose group was higher than that in the low-dose group(P<0.05),and the uncertainty rate was lower than that in the low-dose group(P<0.05).The adverse effects of dyspnea in low dose group were less than those in high dose group(P<0.05).There was no significant difference in other data between groups(P>0.05).Conclusion High dose131-I was better than low dose 131-I,and the therapeutic response was better than that of low dose 131-I.