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目的 分析131I治疗分化型甲状腺癌骨转移的结果。方法 回顾性分析 32例接受131I治疗的分化型甲状腺癌骨转移患者 ,其中 14例骨转移灶在131I治疗前接受手术治疗。结果 全组 5年和 10年总生存率分别为 91%和 79% ,骨转移后 5年和 10年生存率分别为 71%和 5 3 %。 2 4例骨转移伴有疼痛 ,131I治疗止痛有效率 (完全缓解和部分缓解 )为 88% ,其中完全缓解率为 5 0 % ,部分缓解率为 38%。 18例接受单纯131I治疗者 ,无 1例骨病灶完全消除 ,而手术加131I治疗的 14例中 ,9例骨病灶完全消除者均为单发骨转移灶。结论 131I是治疗分化型甲状腺癌骨转移的有效治疗手段 ,能缓解骨疼痛 ,并对部分骨转移灶有消除作用。手术合并131I治疗分化型甲状腺癌局限的骨转移灶可以有效地消除病灶 ,建议对局限性骨转移灶行手术加131I综合治疗
Objective To analyze the results of 131I treatment of differentiated thyroid cancer with bone metastases. Methods Thirty-two patients with differentiated thyroid cancer with bone metastases treated with 131I were retrospectively analyzed. Among them, 14 patients with bone metastases received surgical treatment before 131I treatment. Results The overall 5-year and 10-year survival rates for the whole group were 91% and 79%, respectively. The 5-year and 10-year survival rates after bone metastases were 71% and 53%, respectively. Twenty-four cases of bone metastases were associated with pain. The effective rate (complete remission and partial remission) of 131I treatment was 88%. The complete remission rate was 50% and the partial remission rate was 38%. Eighteen patients who received 131I treatment alone had no bone lesions completely eliminated. Of the 14 patients who had surgery plus 131I treatment, 9 patients who completely eliminated bone lesions were single bone metastases. Conclusion 131I is an effective treatment for the treatment of differentiated thyroid cancer with bone metastases. It can relieve bone pain and eliminate bone metastases. Surgery combined with 131I treatment of differentiated thyroid cancer limited bone metastases can effectively eliminate the lesions, it is recommended that surgery combined with 131I surgery for localized bone metastases