土耳其西部分化型甲状腺癌的低剂量放射性碘消融治疗(1.11GBq)。

B Karasah Erkek, H Sariyildiz Gumusgoz, A Oral, B Yazici, A Akgun
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引用次数: 0

摘要

目的:在低风险分化型甲状腺癌(DTC)病例中采用消融治疗,通过消除残留甲状腺组织,将甲状腺球蛋白(Tg)水平降至术后可测量水平以下,从而便于对患者进行监测。然而,有效消融所需的最小活性剂量仍不确定。选择低剂量[131I]-NaI进行消融为患者和医疗服务提供了多项优势。特别是对于预期寿命较长(10 年后约为 90-95%)的肿瘤患者,[131I]-NaI 治疗不应对患者治疗后的生活构成风险,也不会影响他们的生活质量。然而,需要明确确定预测成功消融的因素:方法:回顾性研究了287例接受低剂量1110 MBq(30 mCi)[131I]-NaI消融治疗的DTC患者的临床数据、实验室检查结果和影像学检查。消融后的影像学和实验室检查结果分为消融成功/失败两类。成功消融组是根据 ATA 标准中列出的极佳反应标准确定的。分析了临床、病理结果、生化常见变量与治疗失败之间的关系:结果:根据 ATA 标准,77% 的患者在消融术后获得了极佳反应。男性性别和消融当天的高 Tg 水平(Tg 临界值:10 纳克/毫升和 5.35 纳克/毫升)与消融失败有关:我们的研究结果表明,1110MBq(30mCi)的消融剂量足以使大多数低风险 DTC 病例在 6-12 个月后获得极佳反应。在选择消融剂量时,除了指南中提到的组织学标志物和年龄外,我们还发现刺激 Tg 值和性别可能是预测消融成功的重要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Low dose radioactive iodine ablation therapy (1.11GBq) for differentiated thyroid cancer in Western Turkey.

Objective: Ablation therapy is employed in low-risk differentiated thyroid cancer (DTC) cases to facilitate patient monitoring by reducing thyroglobulin (Tg) levels to measurable levels below after surgery by eliminating residual thyroid tissue. However, there is still uncertainty about the minimum activity dose required for effective ablation. Opting for low-dose [131I]-NaI for ablation offers several advantages for both patients and healthcare services. Particularly in this tumor group with a high life expectancy (approximately 90-95 % at 10 years), [131I]-NaI treatment should not pose a risk to the patient's post-treatment life and should not compromise their quality of life. However, there is a need for a well-defined identification of factors predicting successful ablation.

Methods: Clinical data, laboratory findings, and imaging tests of 287 patients with low-dose 1110 MBq (30 mCi) [131I]-NaI ablation therapy for DTC were retrospectively reviewed. Post-ablation imaging and laboratory findings categorized ablation success/failure. The successful ablation group was determined according to the excellent response criteria outlined in ATA criteria. Relationships between clinical, pathological findings, biochemical common variables, and treatment failure were analyzed.

Results: An excellent response was achieved in 77% of the entire group according to ATA criteria post-ablation. Male gender and high Tg levels on the day of ablation (Tg cut-off: 10 ng/mL and 5.35 ng/mL) were associated with unsuccessful ablation.

Conclusions: Our results indicate that a 1110MBq (30mCi) ablation dose is sufficient to achieve an excellent response in most low-risk DTC cases 6-12 months later. When selecting the dose for ablation, besides the histological markers mentioned in guidelines and age, we observed that stimulated Tg values and gender may be important in predicting ablation success.

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