甲状腺癌术后大剂量131I治疗疗效分析

目的探讨甲状腺癌术后大剂量131I治疗的疗效。方法甲状腺次全切或全切术后甲状腺癌患者75例行大剂量131I治疗，具有一叶以下残留甲状腺组织者一次性给予3．7GBq；具有一叶或以上残留组织或伴有转移病灶者，先一次性给予3．7GBq，3个月后依据显像结果再次给予4．44～7．4GBq治疗转移灶，观察治疗效果。结果大剂量131I治疗甲状腺癌疗效明显，总有效率为94．7％；有、无转移病灶甲状腺癌患者131I治疗后人甲状腺球蛋白水平均明显低于治疗前（P〈0．05）；有转移病灶甲状腺癌患者治疗前、后人甲状腺球蛋白水平均明显高于无转移病灶患者（P〈0．01）。结论大剂量131I去除甲状腺癌残留组织及治疗转移病灶的方法可靠、简便、疗效明显，结合131I全身扫描及人甲状腺球蛋白的检测，可较好预防甲状腺癌的复发。

Therapeutic effect analysis of high-dose 131I therapy for thyroid carcinoma after operation

Objective To explore the therapeutic effect of high-dose 131I therapy for thyroid carcinoma after operation. Methods Seventy 5ire cases of thyroid carcinoma after subtotal or total surgery were treated with high-dose 131 I. A dose of 3.7GBq 131I was once given to the patients with residual thyroid tissue of less than one leaf. Those with one leaf residual thyroid tissue or more, and those complicated with metastases were first given a dose of 3.7 GBq 131 I, followed by a dose of 4.44 to 7.4 GBq 131 1 according to imaging results after three months. Results The therapeutic effect of high dose 131 1 was obvious for thyroid carcinoma, with the total effective rate of 94.7%. Thyroglobulin was lower in patients both with and without metastases after treatment than that before treatment （P〈O. 05）, and was lower in patients without metastases than that in patients with metastases both before and after treatment （P〈0. 01）. Conclusioll High- dose 131I therapy was reliable, simple and effective for thyroid carcinoma. The combination of 131 I whole body scan and detection of thyroglobulin can effectively prevent the recurrence of thyroid carcinoma.