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目的探讨131I在分化型甲状腺癌(differentiated thyroid cancer,DTC)术后清除残留甲状腺组织(清甲)和转移灶(清灶)治疗中的疗效及安全性。方法随机选取100例进行131I清甲及清灶治疗的DTC患者。所有患者治疗前3~4周均停服L-T4,并予以131I(2.96~5.55)×103MBq清甲治疗;治疗后口服L-T4替代治疗,6个月后复查,根据颈部超声、全身显像及血清甲状腺球蛋白(thyroglobulin,Tg)水平评价131I治疗的效果。结果所有的患者均接受1~3次的131I治疗,共140个疗程,平均每次治疗剂量为4.03×103MBq,1次131I治疗成功率为67%,2次131I治疗成功率为92%,经131I治疗后患者的Tg转阴率为53.3%;治疗后5例患者出现一过性白细胞下降,治疗前后肝肾功能无明显改变。结论 DTC患者术后尽早进行规范化的131I治疗,具有治疗次数少、清甲成功率高且不良反应少的特点,对预防甲状腺癌的复发有重要的作用。
Objective To investigate the efficacy and safety of 131I in the treatment of residual thyroid tissue (clearance) and metastasis (clear focus) after differentiated thyroid cancer (DTC). Methods 100 cases of DTC patients treated with 131I and Qingzao were randomly selected. L-T4 was given to all patients 3 to 4 weeks before treatment and 131I (2.96 ~ 5.55) × 103MBq was administered to the patients. After the treatment, oral L-T4 replacement therapy was given and the patients were reviewed after 6 months. According to the results of neck ultrasonography, Imaging and serum thyroglobulin (thyroglobulin, Tg) level evaluation of 131I treatment effect. Results All patients underwent 131I treatment for 1 ~ 3 times with a total of 140 courses with an average dose of 4.03 × 103MBq. The success rate of 131I treatment was 67% and the success rate of 131I treatment was 92% After 131I treatment, the rate of Tg negative conversion was 53.3%. Five patients had transient leukocytopenia after treatment. There was no significant change in liver and kidney function before and after treatment. Conclusions DTC patients with standardized 131I treatment as soon as possible after operation, with fewer treatment times, high success rate and fewer adverse reactions, has an important role in preventing the recurrence of thyroid cancer.