[1]汪开明,青春,吴坚,等.分化型甲状腺癌术后131I治疗的进展[J].国际放射医学核医学杂志,2009,33(3):167-170.[doi:10.3760/cma.j.issn.1673-4114.2009.03.010]
 WANG Kai-ming,QING Chun,WU Jian,et al.The advanced treatment of 131I in patients with differentiated thyroid cancer undergoing subtotal thyroidectomy[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(3):167-170.[doi:10.3760/cma.j.issn.1673-4114.2009.03.010]
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
33
期数:
2009年第3期
页码:
167-170
栏目:
核素治疗
出版日期:
1900-01-01

文章信息/Info

Title:
The advanced treatment of 131I in patients with differentiated thyroid cancer undergoing subtotal thyroidectomy
作者:
汪开明 青春 吴坚 罗卫华 朱云芝 申泓
363医院核医学科, 成都 610041
Author(s):
WANG Kai-ming QING Chun WU Jian LUO Wei-hua ZHU Yun-zhi SHEN Hong
Department of Nuclear Medicine, 363 Hospital, Chengdu 610041, China
关键词:
甲状腺肿瘤碘放射性同位素近距离放射疗法
Keywords:
Thyroid neoplasmsIodine radioisotopesBrachytherapy
DOI:
10.3760/cma.j.issn.1673-4114.2009.03.010
摘要:
甲状腺癌的发病率近年有增高趋势。由于甲状腺癌多以甲状腺结节首诊,在国内首次手术以肿瘤切除或甲状腺部分切除居多,占90.5%。原发灶再次手术肿瘤残留率达41.3%,颈淋巴结转移率72.8%。鉴于再次手术常伴喉返神经损伤和甲状旁腺功能减低等并发症,多数患者不愿再次手术。131I对术后剩余甲状腺组织可去除隐藏在残留甲状腺组织中的微小癌灶而降低甲状腺癌的复发率,也可破坏或抑制具有吸131I功能的转移灶,有利于长期随访评判及监测肿瘤的复发和转移情况。大量文献报道,低剂量(1.11GBq)131I对于分化型甲状腺癌单叶切除患者的首次去除率接近60%,重复治疗后的去除率超过90%。低剂量131I治疗分化型甲状腺癌术后残余组织可以缩短住院时间,减少额外辐射作用,降低可能的不良反应,并减少患者的经济负担,以达到尽可能大的临床去除治疗效果。
Abstract:
Thyroid cancer account approximately 1.3%-1.5% of cancers all over the body, the attack rate is raising up recently. Most operation is subtotal thyroidectomy at the first time, because thyroid cancer was regarded as thyroid nodule usually account 90.5%. Operation one more time with leftover cancer rate about 41.3%, and with lymphonodi cervicales deadexis about 72.8%. Most patient reluctancy operation again in view of complication with hypoparathyroidism and injure of recurrent nerve. The efficacy of radioiodine ablation can eliminate the minimum cancer which concealed in remained thyroid glandular tissue, and cut down the recurrence rate of thyroid cancer, and destroy metastasis, in favour of long-term follow-up. A great quantity of literature report about 60% with 1.11GBq 131I and 90% with retreatment with 1.11GBq 131I in patients with differentiated thyroid cancer undergoing subtotal thyroidectomy.131I treatment can shorten length of stay, and decrease radiation effect, and cut down side effect and economy burden, as far as possible to achieve therapeutic efficacy.

参考文献/References:

[1] Hackshaw A, Harmer C, Mallick U, et al. 131I aetivity for remnant ablation in patients with differentiated thyroid cancer:a systematie review. J Clin Endocrinol Metab, 2007, 92(1):28-38.
[2] Pacini F, Schlumberger M, Harmer C, et al. Post-surgical use of radioiodine (131I) in patients with papillary and follicular thyroid cancer and the issue of remnant ablation:a consensus report. Eur J Endocrinol, 2005, 153(5):651-659.
[3] Dewil B, Van Damme B, Vander poorten V, et al. Completion thyroidectomy after the unexpected diagnosis of thyroid cancer. BENT. 2005, 1(2):67-72.
[4] Bal CS, Kumar A, Pant GS. Radiniodine dose for remnant ablation in differentiated thyroid carcinoma:a randomized clinical trial in 509 patients. J Clin Endocrinol Metab, 2004, 89(4):1666-1673.
[5] Hoyes KP, Owens SE, Millns MM, et al. Differentiated thyroid cancer:radioiodine following lobectomy-a clinical feasibility study. Nucl Med Commun, 2004, 25(3):245-251.
[6] Leblanc G, Tabah R, Liberman M, et al. Large remnant 131I ablation as an alternative to completion/total thyroidectomy in the treatment of well-differentiated thyroid cancer. Surgery, 2004,136(6):1275-1280.
[7] Allan E, Owens SE, Waller ML, Differentiated thyroid cancer:lobectomy and radioiodine, a treatment suitable for all cases?. Nucl Med Commun, 1999, 20(11):983-989.
[8] Shingu K, Kobayashi S, Yokoyama S, et al. Effectiveness of preoperative radioactive iodine (131I) therapy for locally advanced papiliary thyroid cancer:a ease report. Thyroid, 1998, 8(12):1113-1116.
[9] Karam M, Gianoukakis A, Feustel PJ, et at. Influence of diagnostic and therapeutic doses on thyroid remnant ablation rates. Nucl Med Commun, 2003, 24(5):489-495.
[10] McCowen KD, Adler RA, Ghaed N, et al. Low dose radioiodine thyroid ablation in postsurgical patients with thyroid cancer. Am J Med, 1976, 61(1):52-58.
[11] Rosário PW, Reis JS, Barroso AL, et al. Efficacy of low and high 131I doses for thyroid remnant ablation in patients with differentiated thyroid carcinoma based on post-operative cervical uptake. Nucl Med Commun, 2004, 25(11):1077-1081.
[12] Bal CS, Kumar A, Chandra P, et al. A prospective clinical trial to assess the effieacy of radioiodine ablation as an alternative to completion thyroidectomy in patients with differentiated thyroid cancer undergoing sub-total thyroidectomy. Acta Oncol, 2006, 45(8):1067-1072.
[13] Bal CS, Kumar A, Pant GS. Radioiodine lobar ablation as an alternative to eompletion thyroidectomy in patients with differentiated thyroid cancer. Nucl Med Commun, 2003, 24(2):203-208.
[14] Vermiglio F, Violi MA, Finocchiaro MD, et al. Short-term effectiveness of low-dose radioiodune ablative treatment of thyroid remnants alter thyroidectomy for differentiated thyroid cancer. Thyroid.1999,9(4):387-391.
[15] Ronga G, Filesi M, Montesano T, et al. Lung metastases from differentiated thyroid carcinoma. A 40 years’ experience. Q J Nucl Med Mol Imaging, 2004, 48(1):12-19.
[16] Loh KC, Grecnspan FS, Gee L, et al. Pathological tumor-nodemetastasis (pTNM) staging for papillary and follicular thyroid carcinomas:a retrospective analysis of 700 patients. J Clin Endocrinol Metab, 1997, 82(11):3553-3562.
[17] Hall FT, Beasley N J, Eski S J, et al. Predictive value of serum thyroglobutin after surgery for thyroid carcinoma. Laryngoscope, 2003,113(1):77-81.
[18] Links TP, van Tol KM, Jager PL, et al. Life expectancy in differentiated thyroid cancer:a novel approach to survival analysis. Endocr Relat Cancer, 2005,12(2):273-280.

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备注/Memo

备注/Memo:
收稿日期:2008-11-18
通讯作者:青春,E-mail:25qingchun000@163.com
更新日期/Last Update: 1900-01-01