Analysis Of The Efficacy And Influence Factors Of ¹³¹I Therapy For Lung Metastases Of Differentiated Thyroid Carcinoma

Objective To analyze the clinical data of ¹³¹I therapy for lung metastases of differentiated thyroid carcinoma?DTC?,and to evaluate its therapeutic effect;To screen out the independent factors of ¹³¹I therapy for lung metastases of DTC,and to establish the logistic multiple factor regression equation;At the same time,to observe the side effects during the ¹³¹I treatment and follow-up period.Methods:?1?Materials:A total of 52 patients with DTC with lung metastases underwent standardized ¹³¹I treatment were enrolled in the department of nuclear medicine of Anhui Provincial Hospital from January 2009 to June 2016.?2?Grouping:According to the 2012?thyroid nodules and differentiated thyroid carcinoma diagnosis and treatment guidelines ? recommended criteria for the efficacy of DTC patients,52 patients were divided into effective group?33 cases?and invalid group?19 cases?.?3?Methods:Whether ¹³¹I is effective in the treatment of DTC with lung metastases is dependent variable,age,gender,times of lung metastases by ¹³¹I imaging,cumulative doses,pathological classification,¹³¹I uptake pattern,Tg levels before treatment,Chest X-ray and?or?CT finding,other distant metastases,cervical lymph node metastases and other 10 factors are independent variables,univariate analysis of the above variables,then multivariate analysis of independent variables with statistical significance.Meantime,the dynamic changes of salivary gland function and peripheral blood indexes in 52 patients during the ¹³¹I treatment and follow-up period were analyzed.Statistical methods included t test,X² test,analysis of variance and Logistic regression analysis.Results:52 cases of DTC with lung metastases after ¹³¹I treatment,cured 5 cases?9.6%?,improved in 28 cases?53.9%?,invalid in 19 cases?36.5%?,the total effective?including cured and improved?rate of 63.5%?33/52?,The efficiency is 36.5%?19/52?.Univariate analysis showed age,times of lung metastases by ¹³¹I imaging,Tg levels before treatment,Chest X-ray and?or?CT finding and other distant metastases were statistically significant?P <0.05?.Multivariate analysis showed that age,other distant metastases,and Tg levels before treatment were independent factors affecting the efficacy of ¹³¹I therapy for DTC with lung metastases.Logistic regression equation Logit P = 6.354-1.988 × with other distant metastases-0.073 × age-0.02 × Tg levels before treatment.Paired t test showed that there was significant difference in WBC and PLT between before the first ¹³¹I treatments and the last ¹³¹I treatment after six months?P <0.05?.Analysis of variance showed that there was no significant difference in the peripheral blood indexes?including WBC,RBC,PLT and Hb?in different ¹³¹I cumulative dose groups?P > 0.05?.X² test showed that there was a significant difference in the degree of salivary gland damage between different ¹³¹I cumulative dose groups?P<0.05?.Conclusion:¹³¹I is an effective method for the treatment of DTC with lung metastases,many factors affect the efficacy of ¹³¹I treatments.Age,other distant metastases,and Tg levels before treatment were independent factors affecting the efficacy of ¹³¹I therapy for DTC with lung metastases.The younger,the significant decrease of Tg levels before treatment and only lung metastases indicate a well prognosis.In the present study,¹³¹I treatment has certain effect on WBC and PLT,however,the mean values of peripheral blood in each group were still within the normal range.There was no significant correlation between the ¹³¹I cumulative dose and the peripheral blood indexes?including WBC,RBC,PLT and Hb?,it was significantly correlated with the extent of salivary gland damage.In summary,¹³¹I treatment is an effective method for the treatment of DTC with lung metastases,and less adverse reactions.