摘要
目的:分析分化型甲状腺癌(DTC)患者131I治疗后体内放射性残留活度变化趋势及影响因素。方法:前瞻性收集2018年11月至2019年2月于天津医科大学总医院接受131I治疗的132例DTC患者[男34例,女98例,年龄(42.8±12.8)岁]的临床资料,患者分为首次治疗(FT)组(88例)和复次(131I治疗次数≥2次)治疗(RT)组(44例)。FT组中,清除残留甲状腺组织(简称清甲)30例、辅助治疗33例、清甲兼顾清除手术不能切除的DTC转移灶(简称清灶)25例;RT组中,清甲18例、清灶26例。131I治疗剂量:清甲3.70 GBq,辅助治疗3.70~5.55 GBq,清灶5.55~7.40 GBq。采用全身动态辐射监测系统测定患者131I治疗后24、48和72 h的体内放射性残留活度,比较组间差异。采用两独立样本t检验、χ^2检验及二元logistic回归探讨放射性残留活度的影响因素。结果:FT组131I治疗后24 h体内放射性残留活度明显低于RT组[(880.60±396.64)和(1022.31±503.94)MBq;t=-2.765,P=0.035]。FT组中,辅助+清甲兼顾清灶亚组131I治疗后24、48 h的体内放射性残留活度高于清甲亚组[24 h:(987.16±447.33)和(766.27±277.87)MBq,48 h:(233.47±146.52)和(183.52±90.65)MBq;t值:-2.711和-2.021,均P<0.05]。RT组中,清灶亚组131I治疗后24、48和72 h的体内放射性残留活度分别为(1246.90±531.69)、(244.57±131.35)和(90.65±67.37)MBq,均高于清甲亚组[(715.50±300.07)、(149.85±68.82)和(58.46±31.45)MBq;t值:-3.822^-2.682,均P<0.05]。17.4%(23/132)的患者(FT组10例,RT组13例)131I治疗后48 h体内放射性残留活度>400 MBq,治疗后72 h所有患者体内放射性残留活度<400 MBq。T分期、N分期、刺激性甲状腺球蛋白(sTg)及131I治疗剂量影响体内放射性残留活度(t值:-2.562~4.211,χ^2值:3.988~8.332,均P<0.05),其中T分期及131I治疗剂量是影响放射性残留活度的独立因素(Walds值:4.253~14.035,均P<0.05)。结论:DTC患者131I治疗后24 h体内放射性残留活度较高,应注意指导隔离防护,131I治疗后72 h可达�
Objective To analyze the trends and influencing factors of residual radioactivity in patients with differentiated thyroid carcinoma(DTC)after 131I therapy.Methods A total of 132 DTC patients(34 males,98 females;age(42.8±12.8)years)who received 131I therapy from November 2018 to February 2019 in Tianjin Medical University General Hospital were prospectively analyzed.Patients were divided into first treatment(FT)group(n=88)and repeat treatment(RT;with 131I treatment≥2 times)group(n=44).In FT group,there were 30 patients received 131I for remnant ablation,33 patients for adjuvant therapy and 25 patients for therapy.In RT group,there were 18 patients received 131I for remnant ablation and 26 patients for therapy.131I dosage:3.70 GBq for remnant ablation therapy,3.70-5.55 GBq for adjuvant therapy,5.55-7.40 GBq for therapy.The residual body radioactivity of patients was monitored at 24,48 and 72 h after the administration of 131I by dynamic radiation whole-body scanner and compared among groups.All clinical data were reviewed to explore the factors associated with the residual radioactivity.Independent-sample t test,χ^2 test and logistic regression analysis were used to analyze the data.Results At 24 h after 131I therapy,the residual radioactivity of patients in FT group were significantly lower than those in RT group((880.60±396.64)vs(1022.31±503.94)MBq;t=-2.765,P=0.035).In FT group,the residual radioactivity of patients with 131I adjuvant therapy+therapy at 24 and 48 h after 131I administration were higher than those with 131I ablation(24 h:(987.16±447.33)vs(766.27±277.87)MBq,48 h:(233.47±146.52)vs(183.52±90.65)MBq;t values:-2.711 and-2.021,both P<0.05).In RT group,the residual radioactivity of patients with 131I therapy at 24,48 and 72 h after 131I administration were(1246.90±531.69),(244.57±131.35)and(90.65±67.37)MBq respectively,which were higher than those with 131I ablation((715.50±300.07),(149.85±68.82)and(58.46±31.45)MBq;t values:from-3.822 to-2.682,all P<0.05).There were 17.4%(23/132;10 patien
作者
季艳会
郑薇
谭建
王任飞
Ji Yanhui;Zheng Wei;Tan Jian;Wang Renfei(Department of Nuclear Medicine,Tianjin Medical University General Hospital,Tianjin 300052,China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2020年第12期721-725,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家自然科学基金(81601523)。
