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分化型甲状腺癌术后首次131I治疗时间选择对疗效的影响
引用本文:刘日信1,李建芳2,曾凤伟1,谢良骏2,程木华2. 分化型甲状腺癌术后首次131I治疗时间选择对疗效的影响[J]. 现代肿瘤医学, 2018, 0(19): 3042-3045. DOI: 10.3969/j.issn.1672-4992.2018.19.011
作者姓名:刘日信1  李建芳2  曾凤伟1  谢良骏2  程木华2
作者单位:1.深圳市宝安区人民医院核医学科,广东 深圳 5181012.中山大学附属第三医院核医学科,广东 广州 510630
基金项目:深圳市宝安区科技计划基金资助项目(编号:2015024)
摘    要:目的:探讨分化型甲状腺癌(DTC)术后首次131I治疗时间选择对疗效的影响。方法:回顾性分析2013年5月至2017年2月于中山大学附属第三医院首次接受131I治疗的DTC患者329例。根据2013年国内131I治疗分化型甲状腺癌指南,131I治疗剂量为30~200 mCi,131I治疗后6个月行疗效评估,疗效分为临床治愈、好转、稳定、进展。根据2015版ATA指南将131I治疗前患者分为中危、高危;按手术与131I治疗时间间隔分为四组:A组(<1个月)、B组(1~3个月)、C组(>3~6个月)、D组(>6~12个月)。分析四组不同时间间隔的DTC患者疗效是否有差异。采用χ2检验、Fisher确切概率法分析数据。结果:各组中年龄及性别构成比等无显著性差异。中危DTC患者中不同时间间隔的四组疗效无差异(P=0.937)。高危DTC患者中不同时间间隔的四组疗效有差异(P=0.017),D组的疗效差于其他各组,其余各组间疗效无差异。结论:中危DTC患者手术后12个月内行首次131I治疗时间间隔对疗效影响不大。高危DTC患者中时间间隔>6~12个月组的疗效较其他组差,建议高危DTC患者宜在手术后6个月内进行首次131I治疗。

关 键 词:分化型甲状腺癌  时间间隔  131I  疗效

Effect of time selection on initial 131I treatment in post-surgery patients with differentiated thyroid cancer
Liu Rixin1,Li Jianfang2,Zeng Fengwei1,Xie Liangjun2,Cheng Muhua2. Effect of time selection on initial 131I treatment in post-surgery patients with differentiated thyroid cancer[J]. Journal of Modern Oncology, 2018, 0(19): 3042-3045. DOI: 10.3969/j.issn.1672-4992.2018.19.011
Authors:Liu Rixin1  Li Jianfang2  Zeng Fengwei1  Xie Liangjun2  Cheng Muhua2
Affiliation:1.Department of Nuclear Medicine,People's Hospital of Baoan District,Guangdong Shenzhen 518101,China;2.Department of Nuclear Medicine,The Third Affiliated Hospital of Sun Yat-sen University,Guangdong Guangzhou 510630,China.
Abstract:Objective:To explore the effect of time selection on initial 131I treatment in post-surgery patients with differentiated thyroid cancer.Methods:A total of 329 DTC patients who received initial 131I treatment in the Third Affiliated Hospital of Sun Yat-sen University from May 2013 to February 2017 were retrospectively analyzed.The treatment dosage was set between 30 and 200 mCi according to the 2013 China Guideline for 131I treatment of DTC.Based on the effective assessment conducted 6 months after therapy,the results were crafted as clinically cured,improved,stable and progressed.329 patients were categorized as medium risk and high risk according to 2015 ATA Guideline and were further divided into 4 groups on a time-based basis,namely group A(<1 month),group B(1~3 months),group C(>3~6 months) and group D(>6~12 months).Differences of response of each group were evaluated by chi-square test and Fisher's exact test.Results:The ages and gender ratios in the all 4 groups were comparable.For medium risk patients,differences of response for each time interval group were not statistically significant(P=0.937).For high risk patients,the response varied from each group (P=0.017).Group D has an inferior response compared to other 3 groups,where the responses for other 3 groups were comparable.Conclusion:The different time interval within 12 months of initial 131I treatment doesn' t have significant impact on response for medium risk DTC patients.For high risk patients,treatment response of group D (>6~12 months) was inferior compared to other groups.It is advised that high risk patients should apply for the initial 131I treatment within 6 months after thyroid surgery.
Keywords:differentiated thyroid carcinoma   time interval   iodine-131   curative effect
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