分化型甲状腺癌术后首次^(131)I治疗时间选择对疗效的影响  

Effect of time selection on initial ^(131)I treatment in post-surgery patients with differentiated thyroid cancer

作　　者：刘日信 李建芳[2] 曾凤伟[1] 谢良骏[2] 程木华[2] Liu Rixin;Li Jianfang;Zeng Fengwei;Xie Liangjun;Cheng Muhua(Department of Nuclear Medicine,People＇s Hospital of Baoan District,Guangdong Shenzhen 518101,China;Department of Nuclear Medi-cine,The Third Affiliated Hospital of Sun Yat-sen University,Guangdong Guangzhou 510630,China.)

机构地区：[1]深圳市宝安区人民医院核医学科,广东深圳518101 [2]中山大学附属第三医院核医学科,广东广州510630

出　　处：《现代肿瘤医学》2018年第19期3042-3045,共4页Journal of Modern Oncology

基　　金：深圳市宝安区科技计划基金资助项目(编号:2015024)

摘　　要：目的:探讨分化型甲状腺癌(DTC)术后首次^(131)I治疗时间选择对疗效的影响。方法:回顾性分析2013年5月至2017年2月于中山大学附属第三医院首次接受^(131)I治疗的DTC患者329例。根据2013年国内^(131)I治疗分化型甲状腺癌指南,^(131)I治疗剂量为30～200 mC i,^(131)I治疗后6个月行疗效评估,疗效分为临床治愈、好转、稳定、进展。根据2015版ATA指南将^(131)I治疗前患者分为中危、高危;按手术与^(131)I治疗时间间隔分为四组:A组(<1个月)、B组(1～3个月)、C组(> 3～6个月)、D组(> 6～12个月)。分析四组不同时间间隔的DTC患者疗效是否有差异。采用χ2检验、Fisher确切概率法分析数据。结果:各组中年龄及性别构成比等无显著性差异。中危DTC患者中不同时间间隔的四组疗效无差异(P=0. 937)。高危DTC患者中不同时间间隔的四组疗效有差异(P=0. 017),D组的疗效差于其他各组,其余各组间疗效无差异。结论:中危DTC患者手术后12个月内行首次^(131)I治疗时间间隔对疗效影响不大。高危DTC患者中时间间隔> 6～12个月组的疗效较其他组差,建议高危DTC患者宜在手术后6个月内进行首次^(131)I治疗。Objective：To explore the effect of time selection on initial^131 treatment in post - surgery patients with differentiated thyroid cancer. Methods ： A total of 329 DTC patients who received initial^131 I treatment in the Third Af- filiated Hospital of Sun Yat-sen University from May-2013 to February-2017 were retrospectively analyzed. The treatment dosage was set between 30 and 200 mCi according to the 2013 China Guideline for ^131 treatment of DTC. Based on the effective assessment conducted 6 months after therapy, the results were crafted as clinically cured, improved, stable and progressed. 329 patients were categorized as mediunl risk and high risk according to 2015 ATA Guideline and were further divided into 4 groups on a time-based basis, namely group A （ 〈 1 month ） , group B （ 1 - 3 months）, group C （〉3-6 months） and group D（〉 6 -12 months）. Differences of response of each group were evaluated by chi-square test and Fisherg exact test. Results ：The ages and gender ratios in the all 4 groups were comparable. For medium risk patients, differences of response for each time interval group were not statistically significant（ P = 0.937）. For high risk patients, the response varied from each group （ P = 0. 017）. Group D has an ilfferior responsecompared to other 3 groups,where the responses for other 3 groups were comparable. Conclusion：The different time interval within 12 months of initial ^131 treatment doesn＇t have significant impact on response for mediunl risk DTC patients. For high risk patients, treatment response of group D （〉 6 -12 months） was inferior compared to other groups. It is advised that high risk patients should apply for the initial ^131 I treatment within 6 months after thyroid surgery.

关 键 词：分化型甲状腺癌 时间间隔 ^131I 疗效 

分 类 号：R736.1[医药卫生—肿瘤]