放射性131Ⅰ治疗分化型甲状腺癌肺转移的疗效及其主要预后因素的系统评价

目的 对放射性131Ⅰ治疗分化型甲状腺癌肺转移的疗效及其主要预后因素进行系统评价.方法 计算机枪索了5个数据库.检出有关放射性131Ⅰ治疗分化型甲状腺癌肺转移疗效及其预后因素的文献,从中提取与131Ⅰ治疗及主要预后因素有关的患者的5年和(或)10年生存率,并用RevMan4.2软件进行统计分析.结果 共纳入11个回顾性队列研究.统计分析结果提示:接受131Ⅰ治疗与未接受131Ⅰ治疗患者的5年生存率分别为74.9%和27.1%.二组患者的10年生存率分别为60.8%和12.2%,二者之间的差异有统计学意义(P<0.01);仅肺转移患者的5年及10年生存率均高于合并多处转移的患者(P<0.01);乳头状甲状腺癌患者的5年及10年生存率均高于滤泡状甲状腺癌患者的5年(P=0.01)及10年生存率(P=0.002);男性与女性患者的5年及10年牛存率没有差异(P>0.05).结论 131Ⅰ治疗能明显提高分化型甲状腺癌肺转移患者的生存率;转移范围和组织学类型是分化型甲状腺癌肺转移患者的两个重要预后因素;患者的预后不受性别的影响.

A systematic review of the effect of radioiodine.131 in treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors

Objective To assess the effect of radioiodine-131 (131Ⅰ) on treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors. Methods Five databases were retrieved and all published studies which analyzed the effect of 131Ⅰ on pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors were systematically reviewed. The data about the impact of 131Ⅰ treatment and the main prognostic factors on the 5-yr and 10-yr survival rates of the patients were abstracted. RevMan 4.2 software was used to statistically analyze. Results Eleven retrospective cohort studies were included. The pooled results suggested that the 5-yr survival rates of the patients who received 131Ⅰ therapy and who did not received 131Ⅰl therapy were 74.9% and 27.1% , respectively ;The lO-yr survival rates(P<0.01)of the two groups were 60.8% % 12.2% , respectively;The difference between them had statistical significance (P<0.01). The 5-yr and 10-yr survival rates of the patients only with pulmonary metastases were higher than those of the patients with multiple metastases (P<0.01). The 5-yr (P = 0.01) and 10-yr (P = 0. 002)surviv10al rates of the patients only with papillary thyroid carcinoma were higher than those of the patients with follicular thyroid carcinoma. The 5-yr and 10-yr survival rates of male and female patients were similar(P>0.05). Conclusions 131Ⅰ treatment increases the 5-yr and 10-yr survival rates of patients with pulmonary metastases from differentiated thyroid carcinoma. The extent of metastases and the histologie type of differentiated thyroid carcinoma are two main predicting factors of prognosis. The 5-yr and 10-yr survival rates of patients are not influenced by gender.