^(131)I治疗分化型甲状腺癌骨转移结果  

Treatment results of radioactive iodine for bone metastasis from differentiated thyroid cancer

作　　者：郑容[1] 唐谨[1] 贾莹莹[1] 曹秀华[1] 刘琳[1] 陈盛祖[1] 北京 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院核医学科,北京100021

出　　处：《中华放射肿瘤学杂志》2001年第3期192-195,共4页Chinese Journal of Radiation Oncology

摘　　要：目的　分析131I治疗分化型甲状腺癌骨转移的结果。方法　回顾性分析 32例接受131I治疗的分化型甲状腺癌骨转移患者 ,其中 14例骨转移灶在131I治疗前接受手术治疗。结果　全组 5年和 10年总生存率分别为 91%和 79% ,骨转移后 5年和 10年生存率分别为 71%和 5 3 %。 2 4例骨转移伴有疼痛 ,131I治疗止痛有效率 (完全缓解和部分缓解 )为 88% ,其中完全缓解率为 5 0 % ,部分缓解率为 38%。 18例接受单纯131I治疗者 ,无 1例骨病灶完全消除 ,而手术加131I治疗的 14例中 ,9例骨病灶完全消除者均为单发骨转移灶。结论　131I是治疗分化型甲状腺癌骨转移的有效治疗手段 ,能缓解骨疼痛 ,并对部分骨转移灶有消除作用。手术合并131I治疗分化型甲状腺癌局限的骨转移灶可以有效地消除病灶 。Objective To evaluate the results of 131 I treatment in differentiated thyroid cancer patients with bone metastasis. Methods Thirty two differentiated thyroid cancer patients with bone metastasis were reviewed retrospectively. All patients were treated with 131 I and 14 received operation prior to 131 I treatment. Results The overall 5 and 10 year survivals for all patients were 91% and 79%. The post bone metastasis survivals at 5 and 10 years were 71% and 53%, respectively. Except 8 patients, 24 patients with bone metastasis had skeletal pain as well. Twenty one of 24 (88%) patients were responsive after 131 I treatment with or without surgery, with a complete response of 50% and a partial response of 38%. According to bone metastases evidenced by X ray examination and ECT, none of the 18 patients who received 131 I therapy alone gave a complete remission, whereas 9 of 14 (64%) patients who received surgery and 131 I therapy did so. However, 12 of these 14 patients had had an isolated bone metastasis.Conclusions 131 I is an effective treatment for patients with painful multiple bone metastases. 131 I treatment can offer good pain relief. Surgery,in the form of local tumorectomy, combined with 131 I therapy is able to eliminate bone metastatic lesion altogether for solitary bone metastasis. We suggest that surgery combined with 131 I therapy for patients solitary bone metastasis be preferred.

关 键 词：分化型甲状腺肿瘤 骨转移 碘131 科学 放射治疗 放射性同位素 

分 类 号：R736.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]