The Evaluation Of Effect And Analyse Of Influencing Factors Of ～(131)I Treatment In Lung Metastases Of Differentiated Thyroid Carcinoma

Objective:â‘ The effect of ¹³¹I treatment in lung metastases of differentiatedthyroid carcinoma(DTC) is evaluated by the advance study of ¹³¹I treatmentin lung metastases of DTC.â‘¡Integrate effect, analyse factors that possiblyaffect ¹³¹I treatment in lung matastases of DTC, find the determinate factorsand discuss the mechanism of these factors,provide referrence value for thefuture ¹³¹I treatment in lung matastases of DTC.â‘¢In the process andbehind of ¹³¹I treatment, whether are there side effects, which side effects andthe dose of ¹³¹I leads side-effects are observed and analyzed.Method: Observing advancely 48 cases of patients with lung metastases ofDTC who received ¹³¹I treatment in course of Sep.2004 to Mar.2007 inDepartment of Nuclear Medicine of West China Hospital, the effect of ¹³¹Itreatment in lung metastases of DTC was evaluated, statistical analysisincluding univariate and multivariate were carried out on mang factorsinterrelated with effect of ¹³¹I treatment in lung metastases of DTC, ANOVAwas carried out on change of a lot of index of hemogra, lung function andsalivary function. Result: According to the standard of evaluating the effect of ¹³¹I treatment inlung metastases of DTC, in 48 cases of patients with lung metastases of DTC,the rate of cure was 10.4%, the effective rate was 62.5%, the rate ofinvalidation was 37.5%. During 48 cases of patients, 5 cases of patients werecured, the least dose of ¹³¹I was 450 mCi, the maximal dose was 700 mCi, theaverage dose was 570 mCi; the least therapeutic time was 3 times, the mosttime was 5 times, the average time was 3.8 times. 30 cases of patients wereeffective, the least dose of ¹³¹I firstly appear effect was 100 mCi, the maximaldose was 400mCi, the average therapeutic dose was 260mCi; the leastthepeutic time was once, the most time was 3 times, the average time was 1.9times. During lots of factors influencing on effect of ¹³¹I treatment in lungmetastases of DTC,â‘ univariate logistic regression analysis showed that:patients'age, chest X-Rays or CT, other distant metastases except lung, serumthyroglobulin levels of diagnosing lung metastases and ¹³¹I uptake ratio oflung were factors influencing effect of ¹³¹I treatment in lung metastases ofDTC; sex, histology, cervical lymph node metastases and thyroid remnantshad no influence on effect.â‘¡multivariate logistic regression analysis showedthat: other distant metastases except lung, serum thyroglobulin levels ofdiagnosing lung metastases and ¹³¹I uptake ratio of lung were the maininfluence factors. Except for the mixed function of other factors, the effectiverate of other distant metastases except lung was 0.127 times that of no distantmetastases.â‘¢ANOVA showed that: ¹³¹I treatment in lung metastases ofDTC had no influence on lung function and erythrocyte and chromia ofhemogram, ¹³¹I treatment in lung metastases of DTC had definite influenceon leucocyte and platelet of hemogram and salivary function.â‘£ Nemenyi-Wilcoxon-Wilcox showed that: The groups of ¹³¹I cumulativetreatment dose more than 500mCi was different from groups of ¹³¹Icumulative treatment dose lesser than 500mCi on leucocyte; the groups of¹³¹I cumulative treatment dose more than 750mCi was different from groupsof ¹³¹I cumulative treatment dose lesser than 250mCi on platelet; the groupsof ¹³¹I cumulative treatment dose more than 500mCi was different fromgroups of ¹³¹I cumulative treatment dose lesser than 500mCi on uptake rate ofsalivary gland; each group of ¹³¹I cumulative treatment dose was differentfrom others, the larger the the ¹³¹I cumulative treatment dose was, the lowerthe excrete rate and the uptake rate of salivary gland were.Conclusion: The effective rate of ¹³¹I treatment in lung metastases of DTC ishigh, but there are a lot of influencing factors. Other distant metastasesexcept lung, serum thyroglobulin levels of diagnosing lung metastases and¹³¹I uptake ratio of lung were the certain influence factors. The patients oflung metastases of DTC with no distant metastases, low serum thyroglobulinlevels of diagnosing lung metastases and high ¹³¹I uptake rate of lung havebetter effect. During the studying period, ¹³¹I treatment in lung metastases ofDTC had no influence on lung function, ¹³¹I treatment in lung metastases ofDTC had definite influence on hemogram and salivary function. The more¹³¹I cumulative treatment dose is, the more ¹³¹I treatment has influence onthem. ¹³¹I treatment in lung metastases of DTC is a effective and safe method.There would be directive significance in elevating treatment effect andreducing side effects through the summarize of study of effect, side effectsand influence factors of ¹³¹I treatment in lung metastases of DTC.