131I治疗分化型甲状腺癌肺转移的短期疗效及影响因素

目的探讨131I治疗分化型甲状腺癌（DTC）肺转移的短期疗效及影响因素。方法47例DTC肺转移患者于甲状腺癌手术后接受131I治疗，首次治疗的131I剂量为3．7～7．4GBq（100—200mCi），结合患者具体情况，采用空腹1次口服法。治疗后3个月评价短期疗效。分析年龄、性别、首次131I治疗剂量、首次治疗前血清甲状腺球蛋白（Tg）水平以及肺部转移灶特点对131I治疗短期疗效的影响。结果首次131I治疗结束后3个月，共治愈13例（28％）、好转16例（34％）、无效18例（38％），有效率62％（29／47）。6例患者接受131I治疗2—3次，病情曾明显好转，其后复发，再经131I治疗后无效。女性患者疗效优于男性，首次治疗前血清Tg水平较低者的疗效优于水平较高者（P均〈0．05）。结论131I治疗DTC肺转移有效，性别、首次治疗前血清Tg水平可能与131I治疗DTC肺转移的疗效有关。

Short.term efficacy and influencing factors of 131I treatment of differentiated thyroid carcinoma with lung metastasis

Objective To discuss the short-term efficacy and influencing factors of 1311 administration in the treatment of differentiated thyroid carcinoma （DTC） with lung metastasis. Methods Forty-seven pa- tients diagnosed with DTC with lung metastasis were administered with 131I with a dose of 3. 7 ~ 7.4 GBq （ 100 200 mCi） after thyroid cancer surgery. Combining with the individual situation, single oral administration was given under empty stomach. Short-term efficacy was evaluated at 3th month after treatment. The effect of age, gender, initial therapeutic dose of 1311, serum thyroglobulin （Tg） level before initial therapy and the char- acteristics of lung metastasis upon the short-term efficacy of 131I treatment was analyzed. Results After 3- month initial ~31I treatment, 13 cases （28%） were cured, 16 （34%） improved and 18 （38%） ineffective. The efficacious rate reached 62% （29/47）. Six patients received 2-3 cycles of 131I treatment. The symptoms were significantly alleviated, but recurred and showed ineffectiveness to subsequent 131I administration. The ef- ficacy for female patients was significantly higher than that for male counterparts. The patients with lower serum Tg levels before the first treatment presented with significantly higher efficacy compared with those with higher Tg levels （ all P 〈 0. 05）. Conclusions 131I administration is an effective treatment of DTC with lung metasta- sis. Gender and the serum Tg level prior to the first treatment may be correlated with the clinical efficacy of 131I administration in treating DTC with lung metastasis.