_27131_ⅰ治疗分化型甲状腺癌骨转移的临床分析

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1、中文摘要mI治疗分化型甲状腺癌骨转移的临床研究缓解、病灶保持稳定或缩小，是治疗DTC骨转移的有效手段；单发病灶、单纯骨转移、手术联合131I治疗者预后更好。．关键词：分化型甲状腺癌；骨转移；影像学比较；放射疗法；碘放射性同位素治疗；疗效评价Ⅱ作者：邱忠领指导教师：罗全勇ClinicalStudyof”1IfortheTr—ea—tmentofBoneMeta⋯stasesfrom—Differentiate—dThyroidCancer一．垒!!塑堕Studyof131IfortheTreatmentofBoneMetastasesfromDiffere

2、miatedThyroidCancerAbstractobjectiveBoneisthesecondmostfrequenttargetofdistantmetastasesinDTCpatients．Thetreatmentofbonemetastasis(BM)inassociation谢廿ldifferentiatedthyroidcancer(DTC)representsadifficultchallenge．GiventhepaucityofpatientswithBMandthedifficultyoftreatingthisdisease

3、，fewstudieshaveinvestigatedBMfromDTC．TheaimofthisstudyWastoidentifytheclinicalfeaturesofDTCpatientswithBM，tocomparethevalueofvariousimageologicalmethodsinthedetectionofBMfromDTC，toevaluatetheefficacyof1j1Itreatmentandidentifyitsinfluencingfactors，andtoanalyzethesurvivalratesafter

4、131Itreatmentanditsinfluencingfactors．。MethodsTheclinlicaldataof106DTCpatientswithBMtreatedby1311weieretrospectivelyanalyzed．Thedetectionrateof乃1I-WBS，bonescintigraphyX-ray，CT，MRItodetectBMwerecompared．E伍cacyafter1，1Itreatmentwasassessedbasedonthedynamicchangeofserumthyroglobulin

5、,thepalliationofbonepainandthechangesofimageology．Thevariablesaffectingtheresponseof151Itreatmentwereidentifiedusingunivariateanalysis．SurvivalrateafterBMdiagnosiswereestimatedusingthelifetablemethod．TherelationshipbetweensurvivaltimeandseveralvariableswereassessedusingKaplan—Mei

6、ermethodforunivariatesanalysis．ResultsTheincidencerateofBMWrits8。4％(106／1258)inDTCpatientsinthisstudyandmostofthemwereosteolyticlesions．Ribs，iliumandthoracicvertebratewerethemostcommonsitesofBMinD1℃．Twenty-onepatients(19．8％)presentedwithBMastheinitialpresentationofDTC．BMWasmoreco

7、mmoninpatientsover45yearsold，andwasoftenmulfieentric．Thedetectionrateof131I-WBS,'MⅪ，bonescintigraphy，X-ray、CTtodetectBMwere93．8％、96．6％、47．3％、66．5％、38．2％，respectively．Aftermultiple131Itreatment，serumthyroglobulinlevelweredroppedmarkedlyin34．9％patientsandkeepstablein52．8％patients．B

8、onepainWaspalliatedin39(63．9％)of61patien