| Iodine treatment of residual thyroid tissue after operation and lymph node metastases is the important components of the treatment in differentiated thyroid cancer. Glycididazole Sodium for Injection, as a radiation sensitizer , had curative effects in a variety of solid tumors with the radiation therapy, that of clinical efficacy in thyroid cancer with radiation therapy is not reported .Purpose:To explore the clinical effect of Glycididazole Sodium for Injection to the treatment of residual thyroid tissue after operation and Lymph node metastases after clear thyroid in differentiated thyroid cancer with 131I.Methods:①patients who were cured with 131I to clear thyroid after operation of DTC and internalization /exclusion criteria: All make first 131I treatment After the operation which is total thyroidectomy from 1 to 3 months. After surgery, iodine has been strictly taboo and patients do not take thyroid hormone drugs, TSH>30 mIU/ L. By the thyroid imaging, thyroid bed has residual thyroid tissue imaging and residual thyroid tissue is less than a leaf,its thyroid 131I uptake test exceed 1%. before treatment the patients keep good condition, who have no other serious systemic illness, WBC>4.0×109/L. The effective cases in line are 197 patients who were cured with 131I to clear thyroid after operation of DTC, 166 of the total are papillary thyroid carcinoma, 31 of the total are follicular carcinoma. 45 cases of male, 152 cases of female, the age for first diagnosis 13～68 years old, the average age is 42.5±11.2 years old.②Groups are divided in the patients who cleared thyroid: it was divided into papillary thyroid carcinoma(P group)166 cases and follicular carcinoma (F group)31 cases according to the type of pathology. It was randomly divided into single 131I treatment group(S1 group)and CMNa therapeutic alliance group(T1 group). 78 cases of PS1 group, 88 cases of PT1 group, 13 cases of FS1 group, 18 cases of FT1 group.③Patients with lymph node metastases after total thyroidectomy: patients showed neck lymph node metastasis after treatment to remove the thyroid and, the color Doppler ultrasound, CT and whole-body 131I scan confirmed, with the exception of the neck lymph node, no other distant metastases. 131I-WBS with diagnostic dose confirm the number of lymph node metastasis. In the pretherapy of 131I, the time of food taboos iodine, thyroid hormone is more than 4 weeks,TSH>30 mIU/ L. Before Treatment, patients keep the general good, who have no other system diseases, WBC> 4.0×109/L. 131I-WBS with diagnostic dose confirm the number of imaging cervical lymph nodes. The effective cases in line are 25 patients, 5 cases of male, 20 cases of female, the age is 26～63 years old, the average age is 41.8±8.4years old. The total number of lymph node metastases is 67.④Groups are divided in the patients with lymph node metastases after total thyroidectomy: It was randomly divided into single 131I treatment group(S2 group)and CMNa therapeutic alliance group(T2 group). 12 cases of S2 group, the number of lymph node metastases is 32. 13cases of T2 group, the number of lymph node metastases is 35.⑤Treatment: All the patients who cleared thyroid are given conventional 131I 3.7×109 Bq one-time oral. 131I 5.55×109Bq were both given to treat of lymph node metastases. T1,T2 group: 800mg/m2 according to body surface area, added to the 100 ml normal saline before 131I treatment made the intravenous drip, and finished dripping within 30 minutes. Administer CMNa within 60 minutes to give oral 131I treatment. Once a day, 4 days in a row. S1,S2 group:intravenous drip 100 ml normal saline before 131I in the treatment. the rest of the methods are same with T1, T2 Group.⑥diagnostic criteria: In 3 months after the removal of the thyroid,patients stop using Euthyrox with 46 weeks, TSH is higher than normal levels. 131I uptake test of thyroid bed is less than 1%, 131I imaging with diagnostic dose showed no thyroid tissue imaging in thyroid bed,that is removal of the thyroid completely; Otherwise, that is the removal of incomplete. Diagnostic criteria of lymph node removal: In 3 months after the removal of the thyroid,patients stop using Euthyrox with 46 weeks. TSH is higher than normal levels. 131I-WBS with diagnostic dose confirm the number of imaging cervical lymph nodes.⑦Side effect: At 1 week and 3 months after the operation, before surgery, blood routine, liver function, parathyroid hormone, peripheral blood lymphocytes micronucleus and chromosome are detected.⑧Statistical analysis: used SPSS10.0 software for data processing. Counting material such as clearance rate mke x2 test, the data about side effect make analysis of variance, the significant level ofα= 0.05, Compared the differences of side effect and the rate of clear thyriod and Lymph node of neck.Results:1.The 131I clearance rates of single 131I treatment group and CMNa therapeutic alliance groupin the treatment of removal thyroid are seperately 85.7% and 86.8%, which have no significant difference (P>0.05).2. WBC, RBC, Plt count, converting enzyme alanine aminotransferase, aspartate amino-converting enzyme,γ-Valley GT, parathyroid hormone, the rate of chromosomal aberrations in peripheral blood lymphocytes,patients'adverse effect and abnormal symptom of single 131I treatment group and CMNa therapeutic alliance group bofore or after treatment have no significant difference(P>0.05).3.The 131I clearance rates of lymphoid node of neck in single 131I treatment group and CMNa therapeutic alliance group after the treatment of removal thyroid are seperately 75% and 85.7%, which have significant differences. (P<0.05)4. WBC count, RBC count, Plt count, converting enzyme alanine aminotransferase, aspartate amino-converting enzyme,γ-Valley GT, parathyroid hormone, the rate of chromosomal aberrations in peripheral blood lymphocytes, patients'adverse effect and abnormal symptom of single 131I treatment group and CMNa therapeutic alliance group, thatpurpose to cure lymph node metastases bofore or after treatment have no significant difference between two groups of side-effects. (P> 0.05)Conclusion:CMNa has no obvious radiosensitizing effect in the treatment of removal thyroid with 131I , but can improves the curative effect to lymph node in the treatment of DTC with 131I after removal of thytroid.as well it don't increace the side effects in above-mentioned treatments. CMNa only bring out radiation sensitizing effect to anoxic cell in the tumor.and has no function to the normal residual thyroid. CMNa in the usage of 131I internal exposure is expected to decreace the dose of nuclide and achieve new way to better therapeutic efficacy.
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