The Clinical Analysis Of ¹³¹I Therapy In Postoperative Patients With Differentiated Thyroid Carcinoma

In order to discuss the effect of ¹³¹I treatment on thyroid cancer, this paper analysis the case of Jilin University of china-Japan union Hospital since January 2005 to January 2007, the case was confirmed to the DTC by surgery and pathology and CT。197 cases with DTC, 171 cases is papillary carcinoma (including mixed papillary carcinoma),26 cases is follicular cancer, 48 cases is male and 149 cases is female, the age from 16 to 65 years old, average age is 44 years old, 69 cases use ablation treatment, dual-mode operation for the patients, the near-cutting, and the function of cervical lymph node dissection for 46 cases, 23 cases use a single leaf cut, 128 cases have transfer cancer, 112 cases is lymph metastasis , 10 Cases have lung metastases, bone metastases is six cases. the patient 131I uptake is more than 1 percent, there are remnants thyroid imaging, the incision healed well, the WBC count is not less than 3.0×109 /L, not pregnancy and breast-feeding of patients. In first month before treatment, prohibit the consumption of iodine in food and drugs, stop use T4 treatment4-5 weeks.1,clinics methods1.1treatment:(1) ablation dose of 131I: Conventional , 3.7GBq 131 I was gaven. Dose for Metastasis cancer: after ablation treatment, the treatment of lymph nodes metastatic give 131I4.44GBq. Treatment of distant metastasis give 131I 6.48GBq.(2) after taking 131I 5-7 days ,give a 131I-WBS.(3) latter, given thyroid hormone preparations, TSH be controled in the range of 0.1 0.5 mIU / L.(4) for the prevention of reaction: neck edema, nausea, vomiting, swollen salivary glands will happen , to prevent acute reaction, give patients prednisone,Vitamin B1,vitamin B4,vitamin C.PO.1.2 the standard of Evaluation:1.2.1 ablation evaluation:stop use thyroid hormone tablets or T4 4-6 weeks later, TSH higher than normal level,131I uptake less than one percent, diagnostic imaging dose of 131 I thyroid bed without thyroid tissue.1.2.2 removal standard of metastasis evaluation Cured: 131I-WBS negative, HTg <1.0μg / L, TgAb negative; efficacy: 131 I—WBS found metastases to reduce intake of 131 I or disappeared, or that the decrease of the number of metastases than before treatment , HTg, TgAb go down or disappeared, for the treatment improved.inefficacy standard: before treatment and a new metastasis be displayed, or the increase in the number of metastasis, or metastasis grew up or enhancements, HTg, TgAb go to higher level. inefficacy: before treatment , founding a new metastasis ,appearing new metastasis, or metastasis cancer grew up . HTg, TgAb go to higher level.Clinic reference is nuclear medicine division of《technical specifications》2,side effects observed2.1Chromosomal aberrations in peripheral blood lymphocytes of tests:2.2Taking a routine examination of blood cell, hTg, TgAb, micro rate of chromosomal aberrations, parathyroid hormone (PTH) inspection.before and after7tdays treatment,take examination of 131I-WBS, hTg, TgAb, chromosome aberrations in after treatment 90th days, take the examination of hTg, TgAb, PTH, blood cell, 2.3side-effect investigate: give each patient a paper. Investigation time is one week, according to the common side effects of treatment, choice of the following three issues. 1,whether have the feeling of the neck tightening, neck pain, and throat pain. 2,whether feel the salivary gland swelling after treatment。3,whether they have nausea, vomiting, stomach discomfort symptoms.3,Statistical data processing: The rank and X2 test and t-test (SPSS10.0 statistical software).4,Results: (1) ablation treatment group to remove 64 cases, fully 92.8 percent clearance,the transfer cancer treatment rate is 57.8 percent. (2) side effects: it is slightly reduced and reversible that parathyroid hypofunction quantity, blood cells counts, platelets change .Conclusion: 131I ablation residues DTC and metastasis is a simple, safe and effective. treatment methods . Therefore ,I believe that the DTC patients should be routinely large dose 131 I treatment, in order to reduce the occurrence of side effects can be taken by the fractionation administration treatment.