经皮骨水泥成形术联合131I治疗分化型甲状腺癌骨转移的疗效评价与生存分析  

Efficacy evaluation of percutaneous osteoplasty combined with 131I therapy and survival analysis in patients with bone metastasis from differentiated thyroid carcinoma

作　　者：孙健雯 宋红俊[1] 席闯 吴春根[2] 沈晨天 邱忠领[1] 罗全勇[1] Sun Jianwen;Song Hongjun;Xi Chuang;Wu Chungen;Shen Chentian;Qiu Zhongling;Luo Quanyong(Department of Nuclear Medicine,Shanghai Sixth People′s Hospital,Shanghai Jiao Tong University,Shanghai 200233,China;Department of Interventional Radiology,Shanghai Sixth People′s Hospital,Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院核医学科,上海200233 [2]上海交通大学附属第六人民医院介入放射科,上海200233

出　　处：《中华核医学与分子影像杂志》2020年第6期339-342,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：上海市重中之重医学影像重点学科(2017ZZ02005);上海市临床重点专科项目(shslczdzk03203)。

摘　　要：目的对经皮骨水泥成形术(POP)联合131I治疗分化型甲状腺癌(DTC)骨转移患者的疗效及生存情况进行评估。方法回顾性分析2008年1月至2020年1月间上海交通大学附属第六人民医院的29例行POP与131I联合治疗的DTC骨转移患者(男16例,女13例;年龄24~64岁)的临床资料和临床特征,针对治疗前后的血清甲状腺球蛋白(Tg)变化、骨痛缓解情况进行疗效评价。采用χ2检验寻找可能影响疗效的因素。采用Kaplan-Meier法分析患者治疗后的总生存(OS)。结果经POP联合131I治疗后,血清Tg生化缓解率达68.97%(20/29)。是否合并非骨性远处转移灶、131I治疗总剂量(≥22.2与<22.2 GBq)对血清Tg变化的影响有统计学意义(χ2值:5.448和4.371,均P<0.05)。骨痛缓解率为65.52%(19/29),患者年龄(≥55和<55岁)和131I治疗总剂量对骨痛缓解的影响有统计学意义(χ2值:7.486和5.154,均P<0.05)。患者5年OS率为87.68%,10年OS率达65.76%。结论POP联合131I治疗在一定程度上能缓解骨转移患者的疼痛症状,并能降低Tg水平和改善患者长期生存,是治疗DTC骨转移的有效方法。Objective To explore the efficacy of percutaneous osteoplasty(POP)combined with 131I therapy in patients with bone metastases from differentiated thyroid carcinoma(DTC)and assess the survival.Methods From Januray 2008 to January 2020,29 DTC patients with bone metastases(16 males,13 females,age range:24-64 years)who received POP combined with 131I therapy in Shanghai Sixth People′s Hospital were retrospectively analyzed.Clinical data and characteristics of patients were analyzed.The efficacy and prognosis were evaluated based on the changes of serum thyroglobulin(Tg)and relieving condition of bone pain after the combined treatment.χ2 test was used to determine the association between clinical characteristics and efficacy,and Kaplan-Meier analysis was used to estimate the overall survival(OS)rate.Results The biochemical response rate of serum Tg was 68.97%(20/29)after the combined treatment.For the influence on changes of serum Tg,whether or not combined with non-osseous distant metastasis,and cumulative dose of 131I treatment(≥22.2 vs<22.2 GBq)were statistically significant(χ2 values:5.448 and 4.371,both P<0.05).The rate of bone pain relief was 65.52%(19/29).Age(≥55 vs<55 years)and the cumulative dose of 131I treatment had statistically influences on bone relief(χ2 values:7.486 and 5.154,both P<0.05).The 5-years OS rate of patients was 87.68%,while the 10-years OS rate was 65.76%.Conclusion POP combined with 131I therapy is effective on relieving the pain,reducing the serum Tg to some extent,and improving the long-term survival of DTC patients with bone metastasis.

关 键 词：甲状腺肿瘤 肿瘤转移 骨骼 放射疗法 碘放射性同位素 骨水泥成形术 治疗结果 

分 类 号：R736.1[医药卫生—肿瘤]