131I治疗分化型甲状腺癌肺转移疗效及影响因素的研究

目的 通过对131I治疗DTC肺转移的回顾性研究,评价131I治疗DTC肺转移的疗效;结合疗效,对可能影响131I治疗DTC肺转移疗效的多种因素进行分析.方法 回顾性研究2004年9月至2007年3月期间在华西医院核医学科进行131I治疗的48例DTC肺转移患者,评价131I治疗DTC肺转移的疗效,对可能影响131I治疗DTC肺转移疗效的多种因素进行单因素和多因素分析.结果 按照131I治疗DTC肺转移的疗效评价标准,48例DTC肺转移患者治愈率10.5％、有效率62.5％、无效率37.5％.(1)单因素Logistic回归分析显示:年龄、胸部X线或CT、除肺之外的远处转移、确诊肺转移时的血Tg水平和肺摄取131I率等是影响131I治疗DTC肺转移疗效的因素;性别、肿瘤病理学类型、颈部淋巴结转移、残留甲状腺组织等时131I治疗DTC肺转移疗效无明显影响.(2)多因素逐步Logistic回归分析显示:远处转移、确诊肺转移时的血Tg水平和肺摄取131I率等是影响131I治疗DTC肺转移疗效的主要因素.结论 131I治疗DTC肺转移有较好的疗效.DTC肺转移患者中,无肺之外的远处转移、确诊时的血Tg水平低和肺摄取131I率高的患者1231I治疗效果好.总之,131I治疗DTC肺转移是一种安全有效的治疗方法,通过对131I治疗DTC肺转移疗效和影响因素的研究总结,对今后提高131I治疗效果有较好的指导意义.

Efficacy and influencing factors of 131I therapy for lung metastases of differentiated thyroid carcinoma: a retrospective study

Objective To evaluate the efficacy and influencing factors of ¹³¹Ⅰtherapy for lung metastases of differentiated thyroid carcinoma（DTC）.Methods Forty eight patients with lung metastases of DTC who received ¹³¹Ⅰtreatment in Department of Nuclear Medicine of West China Hospital from September 2004 to March 2007 were retrospectively reviewed.The efficacy and influencing factors of ¹³¹Ⅰtherapy was evaluated with univariate and multivariate analysis.Results In 48 cases with lung metastases of DTC,the complete remission rate of ¹³¹Ⅰtherapy was 10.4%,the response rate was 62.5%and no response rate was 37.5%.Univariate logistic regression analysis showed that the age,chest X-Ray or CT findings,distant metastases other than lung,serum thyroglobulin levels at diagnosis and lung ¹³¹Ⅰuptake rate were factors influencing outcome of ¹³¹Ⅰtherapy;sex,histology,cervical lymph node metastases and thyroid remnants had no influence on efficacy.Multivariate logistic regression analysis showed that distant metastases other than lung,serum thyroglobulin levels at diagnosis and lung ¹³¹Ⅰuptake rate were the influencing factors. Conclusion ¹³¹Ⅰtherapy is an effective and safe method for lung metastases of DTC and some factors would influence the efficacy of the therapy.