放射性131I治疗分化型甲状腺癌术后转移临床研究.docVIP

放射性131I治疗分化型甲状腺癌术后转移临床研究[摘要] 目的:分析放射性131I治疗分化型甲状腺癌术后转移灶的临床观察和远期随访结果。方法:根据患者残留甲状腺组织大小和摄碘率,合理应用131I投放剂量,每位患者治疗1~4个疗程,每个疗程间隔3~8个月,并对22例患者的治疗结果作一疗效分析。结果:22例患者共经49次治疗,有效22例(100%),清除12例(57%),无效0例。结论:放射性131I甲状腺手术彻底、单发软组织转移且转移灶肿块较小者治疗效果较好,反之较差。“手术?131I治疗?甲状腺素抑制”是最佳分化型甲状腺癌综合治疗方案,这一方案可有效降低复发率和转移率。 [关键词] 放射性131I;分化型甲状腺癌;转移灶 [中图分类号] R736.1 [文献标识码]A [文章编号]1674-4721(2010)03(b)-029-02 Clinical analysis of radioactive 131I treatment of differentiated thyroid cancer metastasis SUN Dongbing,SUN Fengying,SHAO Minghua,DONG Fulian (Department of Nuclear Medicine, Central Hospital of Shancounty, Shandong Province, Shan county274300, China) [Abstract] Objective: To study the analysis of radioactive 131I treatment of differentiated thyroid cancer metastases after clinical observation and long-term follow-up results. Methods: Patients with residual thyroid tissue according to the size and iodine intake rate, a reasonable dose of 131I-running, each patient were treated 1 to 4 courses, each course of treatment interval of 3 to 8 months. And an effective analysis of treatment outcomes of 22 patients were made. Results: A total of 22 patients were treated of 49 treatments,22 cases had effect (100%), 12 cases were cleared (57%), 0 cases was without effect. Conclusion:Total thyroidectomy alone, become soft and the organization of the transfer of the lesser of metastatic tumor treatment better, otherwise poor. “The operation was +131I + thyroxine suppression therapy,” This is the best comprehensive treatment of differentiated thyroid cancer program, the program can effectively reduce the incidence of recurrence and metastasis. [Key words] Radioactive 131I;Differentiated thyroid carcinoma;Metastasis 甲状腺癌是一种常见的恶性肿瘤,近年来发病有增高的趋势。分化型甲状腺癌(DTC)约占甲状腺癌总数的80%。分化型甲状腺癌和转移灶具有摄取碘的功能,在去除正常甲状腺组织以及大量TSH的刺激下也能浓聚足够量的131I,131I衰变发射出β射线,在组织内平均射程为1 mm[1],对周围组织器官影响较小,对分化型甲状腺癌细胞起到杀伤作用。分化型甲状腺癌手术前后常发生淋巴结转移、肺转移及远端转移,由于分化型甲状腺癌转移灶位置不同,术中不能完全切除或治疗措施不当,可致淋巴结及转移灶过大,并与周围组织粘连,难以再次手术,有时转移灶相互融合压迫周围器官,引起功能障碍,甚至