分化型甲状腺癌术后大剂量131I“清甲”治疗疗效分析.docVIP

精品论文 参考文献 分化型甲状腺癌术后大剂量131I“清甲”治疗疗效分析 张晓（河南省信阳市中心医院核医学科 464000） 【中图分类号】R736.1【文献标识码】A【文章编号】1672-5085（2012）11-0119-02 【摘要】目的 评价分化型甲状腺癌（简称甲癌DTC）患者术后残余甲状腺组织大剂量131I清除治疗疗效。方法 （1）治疗方法：淋巴结转移患者每次口服3.7～5.55GBq，肺、骨转移患者每次口服5.55～7.4GBq，重复治疗间隔3个月。（2）疗效判断：治愈：131I显像呈阴性，血甲状腺球蛋白（Tg）降至正常水平；有效：131I显像呈转移灶缩小或减少或转移灶摄131I率降低，血甲状腺球蛋白（Tg）转阴。无效：131I显像有新转移灶出现，血甲状腺球蛋白（Tg）高水平。结果 70例甲癌转移灶患者治愈34.3%（24例），有效57.1%（40例），无效8.6%（6例）。结论 采用大剂量131I治疗分化型甲状腺癌转移灶疗效佳。 【关键词】甲状腺肿瘤 肿瘤转移 放射疗法 碘放射性同位素 Analysis on the factors affecting the efficacy of 131I remnant ablation in patients after thyroidectomy for diffentiated thyroid carcinoma 【Abstract】 Objective To observe diffentiated thyroid cancer metastases treated by the multiple lsquo;high dosersquo; 131I . Methods1. Treatment protocol: In case of lymphatic metastasis ,3.7～5.55GBq 131I was given each time , lung and bone metastasis , 5.55～7.4GBq 131I was given each time .The interval between 2 doses was 3 months . 2. Assessment of therapeutic results: negative 131I scanning was marked as cured, lesion size decrease , reduction of the munber of foci or reduction of iodine uptake by the lesion , normal blood thyroglobulin (Tg) indicated effective treatment ; higher blood Tg , appearance of new lesions with ensuing death were considered as treatment failure . Results Of the 70 patients: 24 (34.3%)were cured .effective treatment was shown in 40 patients (57.1%) and treatment failure in 6 patients (8.6%) . Conclusions Multiple high dose therapy in treatment of metastatic thyroid carcinoma is an effective method .Indication can be extended to patients showing lymphatic metastases on operation . 【Key words】Thyroid neoplasms Neoplasm metastasis Radiotherapy Iodine radioisotopes 分化型甲状腺癌的131I治疗，逐渐被临床认可。笔者自2000～2010年对70例甲状腺癌转移患者采用大剂量131I治疗现报道如下。 1 资料与方法 1.1 临床资料 70例患者均经术后病理确诊为分化型甲状腺癌转移，其中男24例，女46例，平均年龄45.6plusmn;12.2岁。70例分化型甲状腺癌中乳头状癌44例，滤泡状癌26例。甲状腺癌（简称甲癌）淋巴结转移44例，131I治疗累积剂量11.1～14.8GBq，平均14.06plusmn;0.37GBq；肺转移18例，131I治疗累积剂量12.95～20.35G