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在最初的治疗后扫描中,从差异化甲状腺癌中获得放射性的淋巴结是否需要重复I治疗?

Yongji Jiang¹, Simin Liu¹, Xiaotong Qiu¹

¹Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.

Frontiers in endocrinology

|June 16, 2023

概括

大约四分之一的差异化甲状腺癌 (DTC) 患者在最初的扫描中具有放射性激活的淋巴结,在一次I治疗周期后保持稳定. 这些患者,特别是具有特定特征的患者,可能不需要重复治疗.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
核医学就是核医学.

背景情况:

在分化甲状腺癌 (DTC) 手术后,残留/复发性淋巴结转移 (LNM) 是常见的.
放射性 (¹³¹I+) 淋巴结在DTC患者初始治疗后经常被观察到.

研究的目的:

为了确定DTC患者在初始治疗后扫描 (PTS) 上具有放射性激活的淋巴结是否需要重复I治疗.
确定影响LNM的DTC患者对初始I治疗的反应的因素.

主要方法:

170名DTC患者的回顾性招募,在初始PTS上有131个I+淋巴结,他们至少接受了两个I治疗周期.
根据2015年美国甲状腺协会 (ATA) 的指导方针,将患者分为完全响应 (CR) 和不完全响应 (IR) 组.
分析与治疗反应相关的临床和成像因素.

主要成果:

24.7%的患者在初始I治疗后达到CR;没有人经历疾病进展.
37%的IR患者在重复治疗后出现改善.
多变量分析确定了刺激性铁血球蛋白 (sTg) 水平 (OR=1.186) 和LNM大小 (OR=1.533) 作为IR的独立风险因素. 最佳的切割值是sTg 18.2μg/l和LNM大小5mm.

结论:

大约25%的DTC患者在初始PTS时具有I+LNM,在没有重复治疗的情况下保持稳定.
患有N0/N1a阶段,较低的sTg,较小的LNM大小,较少的LNM,负的超声特征和没有I-LNM的患者不太可能需要重新治疗.
这一发现有助于为残留/复发性LNM的DTC患者做出个性化治疗决策.

关键词:

第131章我治疗治疗分化的甲状腺癌 (DTC)淋巴结转移是淋巴结的转移.治疗后扫描扫描治疗后扫描.治疗对治疗的反应反应.

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