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目的比较分析~(131)I与放化疗治疗分化型甲状腺癌骨转移的临床疗效及对患者的生存影响。方法选择2008年1月~2012年12月本院收治的分化型甲状腺癌骨转移患者120例,将其随机分为观察组(65例)和对照组(55例),对照组给予放化疗、观察组给予~(131)I治疗,比较两组患者治疗后临床疗效及患者生存状况。结果观察组患者骨痛缓解总有效率为86.15%,对照组为63.64%,两组比较,差异具有统计学意义(P<0.05);观察组治疗后Tg水平显著下降36例、基本稳定18例、无效11例,对照组显著下降13例、基本稳定22例、无效20例,两组比较,差异具有统计学意义(P<0.05);观察组治疗后完全缓解14例、部分缓解21例、稳定15例、进展15例,对照组治疗后完全缓解8例、部分缓解10例、稳定16例、进展21例,两组比较,差异具有统计学意义(P<0.05);观察组患者生存情况明显优于对照组(P<0.05)。结论采用~(131)I治疗分化型甲状腺癌骨肿瘤患者骨痛缓解情况、Tg水平降低情况以及影像学病灶变化均优于常规放化疗治疗,且~(131)I治疗后有助于改善患者的生存情况,可考虑作为分化型甲状腺癌骨转移患者术后治疗的首选措施。
Objective To compare the clinical efficacy of ~ (131) I with radiotherapy and chemotherapy in the treatment of differentiated thyroid cancer with bone metastases and its impact on patients’ survival. Methods A total of 120 patients with differentiated thyroid cancer with bone metastasis admitted in our hospital from January 2008 to December 2012 were randomly divided into observation group (65 cases) and control group (55 cases). The control group received radiotherapy and chemotherapy, The observation group was treated with ~ (131) I, and the clinical efficacy and survival status were compared between the two groups after treatment. Results The total effective rate of pain relief was 86.15% in the observation group and 63.64% in the control group. There was significant difference between the two groups (P <0.05). The Tg level of the observation group decreased significantly after treatment (36 cases) and remained stable in 18 cases , 11 cases were not effective, the control group decreased significantly in 13 cases, basically stable in 22 cases, ineffective in 20 cases, the difference between the two groups was statistically significant (P <0.05); the observation group after complete remission in 14 cases, partial remission in 21 cases, In the control group, 8 cases were completely relieved after treatment, 10 cases were partially relieved, 16 cases were stable and 21 cases progressed. There was significant difference between the two groups (P <0.05). Survival of the patients in the observation group Obviously superior to the control group (P <0.05). Conclusion The treatment of ~ (131) I in treatment of patients with differentiated thyroid carcinoma, the reduction of Tg, the change of Tg, and the change of imaging lesions are superior to those of conventional radiotherapy and chemotherapy, and 131I treatment can improve the patients’ The survival of patients with differentiated thyroid cancer can be considered as the preferred treatment of patients with bone metastases.