甲状腺肿瘤专题研究(Monographic Study of Thyroid Surgery)

碘131 配合选择性颈淋巴结清除术对甲状腺癌的疗效及唾液腺功能的影响

Published at: 2015年第24卷第5期

袁宏钧 1 , 仲妙春 1 , 张静霞 1
1 浙江省人民医院 普通外科,浙江 杭州 310014
通讯作者 宏钧 袁 Email: yuanhongjundaifu@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.05.005
基金:

摘要

目的:探讨I131 配合选择性颈淋巴结清除术治疗甲状腺癌(TC)的疗效和对患者唾液腺功能的影响。方法:选取2009 年1 月—2013 年9 月期间确诊治疗的TC 患者60 例,随机分均分为对照与观察组,对照组患者给予常规甲状腺切除术,观察组患者在此基础上给予选择性颈淋巴结清除术与I131 治疗,其中又根据I131 摄入量均分为高剂量亚组(3 500 mBq)和低剂量亚组(1 000 mBq),分析患者疗效和唾液腺功能指标及术后生存情况。结果:观察组首次清甲成功率与治疗总有效率均明显高于对照组(均P<0.05);唾液腺功能参数方面,手术组优于低剂量亚组,低剂量亚组优于高剂量亚组(均P<0.05);观察组中高、低剂量亚组5 年生存率无明显差异,但均高于对照组(均P<0.05)。结论:I131 配合选择性颈淋巴结清除术治疗可有效提高对TC 手术患者的疗效并改善预后,虽有唾液腺功能方面不良反应,但低剂量治疗症状较轻,在患者接受范围内。


Concomitant I131 therapy following selective neck dissection for thyroid cancer: efficacy and influence on salivary gland function

Abstract

Objective: To investigate the efficacy of concomitant I131 therapy following selective neck dissection in treatment of thyroid cancer (TC) and its influence on the salivary gland function of patients. Methods: Sixty TC patients admitted from January 2009 to September 2013 were selected, and were equally randomized into control group and observational group. Patients in control group underwent conventional thyroidectomy, while those in observational group received additional selective neck dissection and I131 therapy, and this group was further equally divided into high- (3 500 mBq) and low-dose (1 000 mBq) subgroup according to the I131 intake. The treatment efficacy, parameters for salivary gland function and postoperative survival of the patients were analyzed. Results: The initial ablation rate and overall effective rate in observational group were significantly higher than those in control group (both P<0.05); all parameters of salivary gland function in control group were better than those in low-dose subgroup, and in the latter were better than those in high-dose subgroup (all P<0.05). The 5-year survival rate showed no difference between high- and low-dose subgroup of observational group, but both were higher than that in control group (both P<0.05). Conclusion: Concomitant I131 therapy following selective neck dissection can effectively improve the surgical efficacy and prognosis in TC patients, and although it exerts adverse effects on salivary gland function, the symptoms caused by low dose treatment are mild and are within the acceptable limits for the patients.


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引用本文: 宏钧 袁, 妙春 仲, 静霞 张. 碘131 配合选择性颈淋巴结清除术对甲状腺癌的疗效及唾液腺功能的影响[J]. 中国普通外科杂志, 2015, 24(5): 643-647.
Cite this article as: YUAN Hongjun, ZHONG Miaochun, ZHANG Jingxia . Concomitant I131 therapy following selective neck dissection for thyroid cancer: efficacy and influence on salivary gland function[J]. Chin J Gen Surg, 2015, 24(5): 643-647.