分化型甲状腺癌术后131I治疗的进展

The advanced treatment of 131I in patients with differentiated thyroid cancer undergoing subtotal thyroidectomy

  • 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.

     

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