131I联合甲磺酸阿帕替尼治疗分化型甲状腺癌肺转移的短期疗效及安全性研究

目的 探讨¹³¹I联合甲磺酸阿帕替尼治疗分化型甲状腺癌肺转移的短期疗效及安全性。方法 回顾分析2018年10月—2020年10月于我院就诊治疗的分化型甲状腺癌肺转移患者57例,分为对照组(n=30)和联合治疗组(n=27),对照组单纯使用¹³¹I治疗,联合治疗组行¹³¹I联合阿帕替尼治疗。每半年观察并记录两组患者的甲状腺球蛋白(Thyroglobulin,Tg)水平、靶病灶(Target lesions,TL)的基线直径变化情况及靶病灶浓聚放射性灶计数/本底计数(Concentration range count/background count,C/B)的变化情况,同时记录两组患者的不良反应情况。结果 随访结束后联合治疗组Tg水平(36.34±19.72 μg/L)较对照组(122.18±22.98 μg/L)明显降低,差异具有统计学意义(P＜0.001);联合治疗组TL的直径均值(3.55±0.39 mm)较对照组(14.01±1.44 mm)明显缩小,差异具有统计学意义(P＜0.001)。24个月后,联合治疗组DCR和ORR高于对照组(P＜0.01)。联合治疗组C/B值(2.98±0.54)较对照组(25.45±3.00)明显降低,差异具有统计学意义(P＜0.001)。联合治疗组阿帕替尼常见的不良反应为手足综合征6例,高血压4例,皮疹2例,未观察到与阿帕替尼相关的Ⅲ级以上严重不良反应。结论 ¹³¹I联合甲磺酸阿帕替尼治疗分化型甲状腺癌肺转移疗效确切,具有明显的缩瘤效果,达到较高的生化缓解率,同时副作用轻微可控,安全性较高。

Short-term efficacy and safety of 131I combined with apatinib in the treatment of differentiated thyroid cancer with lung metastasis

Objective The Objective of our study was to investigate the short-term efficacy and safety of ¹³¹I combined with apatinib in the treatment of lung metastasis from differentiated thyroid cancer.Methods A retrospective analysis of 57 patients with lung metastases from differentiated thyroid cancer who were treated in our department from October 2018 to October 2020 were divided into the control group(n=30)and the combined treatment group(n=27).The control group was treated with ¹³¹I alone,and the combination group was treated with ¹³¹I combined with apatinib.In both groups of patients,the levels of thyroglobulin(Tg)and baseline diameter were observed and recorded every six months.The changes of baseline diameter changes of target lesions(TL)and concentration range count/background count(C/B)were observed and recorded every six months.At the same time,the adverse reactions of patients in the two groups were recorded.Results After the follow-up,the level of Tg in the combined treatment group(36.34±19.72 μg/L)was significantly lower than that in the control group(122.18±22.98 μg/L),and the difference was statistically significant(P＜0.001).The mean diameter of TL in the combined treatment group(3.55±0.39 mm)was significantly smaller than that of the control group(14.01±1.44 mm),and the difference was statistically significant(P＜0.001).After 24 months,DCR and ORR in the combined treatment group were higher than those in the control group(P＜0.01).The C/B value of the combined treatment group(2.98±0.54)was significantly lower than that of the control group(25.45±3.00),and the difference was statistically significant(P＜0.001).The common adverse reactions of apatinib in the combined treatment group were hand-foot syndrome(6 cases),hypertension(4 cases),and rash(2 cases).No serious adverse reactions of grade Ⅲ or above related to apatinib were observed.Conclusion ¹³¹I combined with apatinib is effective in the treatment of lung metastasis from differentiated thyroid cancer,has obvious tumor shrinkage effect and achieves a high biochemical remission rate,while the side effects are mild and controllable,and the safety is high.