分化型甲状腺癌患者^131I治疗后体内残留放射性活度的评估  

Estimation of residual activity in patients with differentiated thyroid cancer after administration of 131I for therapy

作　　者：汤敏敏[1] 刘建中[2] 武志芳[2] 陆克义[2] 李思进[2] 高永举[1] 武新宇[1] 徐俊玲[1] 

机构地区：[1]郑州大学人民医院河南省人民医院核医学科,450003 [2]山西医科大学第一医院核医学科

出　　处：《中华放射医学与防护杂志》2015年第4期299-302,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 评估分化型甲状腺癌（DTC）患者^131I治疗后体内残留放射性活度.方法 本次前瞻性研究包括49例DTC患者,分为“清甲”（^131I摧毁术后残留的甲状腺组织）与“清灶”（^131I治疗甲状腺床残留甲状腺癌、甲状腺床复发灶和转移灶）组,于服131I后收集患者每次排泄尿液,测定患者每天每次通过尿液排泄的放射性活度及排泄的总放射性活度,进而估算患者体内残留的放射性活度.分别于服^131I后2、6、24、48、72 h进行1 m处剂量当量率的测定,估算患者体内残留放射性活度达到400 MBq时1 m处剂量当量率.结果 服^131I后2、6、24、48、72 h体内残留^131I活度占服131I初始活度的百分比,“清甲”组分别为99％、72％、25％、15％、7％,1 m处剂量当量率分别为157、120、35、11、9 μSv/h;“清灶”组对应百分比分别为99％、71％、18％、7％、3％,1 m处剂量当量率分别为232、182、48、11、2 μSv/h.体内残留的放射性活度与1 m处剂量当量率呈正相关（r=0.94,P ＜0.001）.“清甲”与“清灶”组服^131I后48 ～ 72 h体内残留放射性活度分别为548～ 259及451～248 MBq,对应的1 m处剂量当量率为8～ 10μSv/h.结论 DTC患者于服^131I后48 ～ 72 h体内残留放射性活度达到国家标准规定的400 MBq,即DTC患者1 m处剂量当量率达到8～ 10μSv/h方可出院.Objective To estimate the residual activity in patients with differentiated thyroid cancer （DTC） after administration of ^131I for post-operative therapy.Methods Forty-nine DTC patients were divided into two groups （thyroid remnant ^131I ablation therapy group and group with ^131I treatment for recurrent and metastatic lesions）.Urine excretion of 49 patients with differentiated thyroid cancer after ^131I therapy was collected every time,with the activity of urine excretion and total activity calculated,and then residual activity in patients estimated.The determination of equivalent dose rate at 1 meter point were performed to estimate multi-temporal residual activity in each patient at 2,6,24,48,and 72 h after administration of therapeutic doses of ^131I,respectively.The equivalent dose rate at 1 meter point was indirectly estimated when the residual activity reach to 400 MBq.Correlation and regression were used to evaluate the relationship between residual activity and the equivalent dose rate at 1 m.Results The percentage of residual activity at 2,6,24,48,and 72 h after administration of ^131I,was,respectively,99%,72%,25%,15% and 7% in patients who have undergone thyroid remnant ^131I ablation,and 99%,71%,18%,7% and 3% in those who have undergone 131I treatment for metastatic lesions.The equivalent dose rate at 1 m point was,respectively,157,120,35,11 and 9 μSv/h in the former and 232,182,48,11 and 2 μSv/h in the latter.There is a positive correlation between residual activity and equivalent dose rate at 1 m （r =0.94,P 〈 0.001）.The residual activity at 48-72 h after administration of ^131I was,respectively,548-259 MBq in the former and 451-248 MBq in the latter.The corresponding equivalent dose rate at 1 m ranged from 8 to 10 μSv/h.Conclusions The in vivo residual activity reaches the national standard of 400 MBq （10.8 mCi） in patients with differentiated thyroid cancer during 48-72 h after administration of ^131I and the equivalent dose rate at 1 m ranged from 8 to 10 μSv/h.At this time,r

关 键 词：分化型甲状腺癌 ^131I 放射性活度 尿液 剂量当量率 

分 类 号：R736.1[医药卫生—肿瘤]