分化型甲状腺癌骨转移大剂量131I治疗后出现重度骨髓抑制一例  

A case of severe bone marrow inhibition in the treatment of differentiated thyroid cancer by radionuclide 131I

作　　者：支海明[1] 查清[1] 程小辉 金传德 桂兆康 魏杏云[1] 王凡[1] Zhi Haiming;Zha Qing;Cheng Xiaohui;Jin Chuande;Gui Zhaokang;Wei Xingyun;Wang Fan(Department of Nuclear Medicine,the PLA Navy Anqing Hospital,Anqing 246003,China)

机构地区：[1]中国人民解放军海军安庆医院核医学科,246003

出　　处：《国际放射医学核医学杂志》2019年第1期88-90,共3页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：笔者报道了一例131I治疗分化型甲状腺癌(DTC)骨转移出现重度骨髓抑制的病例,从临床诊断、骨髓造血系统变化、治疗过程是否规范等方面分析该病例特点,并通过文献复习加深了对131I诊治DTC骨转移的疗效以及骨髓造血影响的认识:131I诊治DTC骨转移的临床效果明显,但随着累积剂量的提升以及患者对131I治疗个体敏感度的不同可能会发生骨髓造血系统的白细胞或血小板一过性下降。对于广泛骨转移患者131I治疗时要高度警惕骨髓抑制的发生,要尽可能考虑累积治疗剂量的因素;尽量延长再次治疗的间隔时间;出现骨髓抑制现象时,要择期使用131I治疗。A case of severe bone marrow inhibition in the treatment of differentiated thyroid cancer (DTC) by radionuclide 131I was reported.The characteristics of the case were analyzed based on clinical diagnosis,changes in bone marrow hematopoietic system,and whether the patient's treatment process was standardized.The therapeutic effect of radionuclide 131I in the diagnosis and treatment of DTC bone metastasis and the effect of bone marrow hematopoiesis were reviewed.Radionuclide 131I had considerable clinical effect on the diagnosis and treatment of DTC bone metastasis.However,with the increase of cumulative dose and the difference of sensitivity of patients to 131I treatment,white blood cells or platelets in the bone marrow hematopoietic system may decrease.For the treatment of 131I patients with extensive bone metastasis,the occurrence of bone marrow inhibition should be on highly alert and the cumulative treatment dose should be considered.The interval between retreatment should be maximized.When bone marrow inhibition occurs in patients with extensive bone metastasis,131I treatment should be used selectively.

关 键 词：重度骨髓抑制 分化型甲状腺癌 治疗剂量 131I 骨转移 大剂量 骨髓造血系统 病例特点 

分 类 号：R736.1[医药卫生—肿瘤] R817.5[医药卫生—临床医学]