13-顺式-维甲酸诱导再分化治疗甲状腺癌的前瞻性研究  

Redifferentiation Therapy with 13-CIS Retinoid Acid in Differentiated Thyroid Carcinoma

作　　者：范群[1] 苏新辉[1] 王卫星[1] 苏福[1] 匡安仁[2] 

机构地区：[1]厦门大学附属中山医院核医学科,福建厦门361000 [2]四川大学华西医院核医学科,四川成都610041

出　　处：《现代生物医学进展》2015年第34期6659-6663,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81071182)

摘　　要：目的:13-顺式-维甲酸(13-CIS retinoid acid,13-CRA)诱导再分化治疗131I-诊断剂量全身显像(Diagnostic whole body scan,d WBS)阴性且血清甲状腺球蛋白(Thyroglobulin,Tg)阳性(d WBS-Tg+)的分化型甲状腺癌(Differentiated thyroid carcinoma,DTC)患者,评价其诱导效果及131I治疗效果。方法:选择88例d WBS-Tg+的DTC患者。根据实体瘤疗效评价标准(RECIST)对13-CRA诱导后再采用131I治疗的效果进行评价,记录13-CRA诱导期间出现的副作用。结果:80例患者完成13-CRA诱导治疗,其中49例(61.25%)诱导有效,31例(38.75%)无效。经13-CRA诱导及131I治疗后,完全缓解(CR)0例,不完全缓解(IR)76例(95.00%),病情进展(PD)4例(5.00%)。13-CRA诱导后,131I-治疗剂量全身显像(Therapic whole body scan,t WBS)的结果与治疗效果呈显著的正相关关系,且相关关系密切(相关系数为0.644>0.5;P=0.000<0.05)。13-CRA诱导治疗过程中,出现的毒副反应主要包括粘膜炎、唇炎、结膜炎、脱皮、脱发、胆固醇及转氨酶升高等。结论:13-CRA诱导治疗能提高部分d WBS-Tg+的DTC病灶的摄碘功能,是治疗d WBS-Tg+的DTC患者的一种有效方法。Objective： To evaluate the effectiveness of 13-CIS retinoid acid （13-CRA） for improving ^131I uptake in recurrent/metastasizcd differentiated thyroid carcinoma （DTC） with diagnostic ^131I whole body scan （dWBS）-negative and Tg-positive （dWBS--Tg＋） and therapeutic effects in dWBS-- Tg＋ - treated DTC patients with dWBS--Tg＋ after 13-CRA induction. Methods： The patients （n=88） of dWBS --Tg＋ with DTC were given 13-CRA, followed by ^131I treatment. The clinical outcome was classified and evaluated according to the Response Evaluation Criteria in Solid Tumors （RECIST）. The side-effects were documented according to the common toxicity criteria （CTC） of the European Organization for the Treatment of Cancer （EORTC）. Results： The patients （n=80） finished 13-CRA induction therapy. There were 49 responders （61.25%） and 31 non-responders （38.75%） after 13-CRA induction. The complete responder （CR） was 0, incomplete responder （IR） was 95.00% （76/80）, and progressive disease （PD） was 5.00% （4/80）. After 13-CRA induction, there was significantly positive correlation between tWBS and outcome （Spearman correlation coefficient was 0.644〉0.5, P=0.000〈0.05）. The side effects including mucositis, cheilitis, desquamation, hair loss, pruritus, conjunctivitis and raised transaminases occurred in most patients. Conclusions： 13-CRA induction can increase ^131I uptake in some recurrence/metastases, thus it might be an option for advanced thyroid carcinoma and deserves further investigation.

关 键 词：13-顺式-维甲酸 诱导治疗 分化型甲状腺癌 

分 类 号：R817.8[医药卫生—影像医学与核医学] R736.1[医药卫生—放射医学]