在转移性差异化甲状腺癌中最佳的累积I-131活性:平衡有效性和不良事件
Mangu Srinivas Bharadwaj1, Sanjana Ballal1, Chandrasekhar Bal1
1Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
The Journal of clinical endocrinology and metabolism
|January 12, 2024
概括
对于转移性差异化甲状腺癌 (mDTC) 患者,高达1000mCi的I-131累积活性 (CA) 平衡了治疗效益和不良事件. 较高剂量增加了骨髓抑制和肺部问题等风险.
科学领域:
- 在瘤学瘤学.
- 核医学就是核医学.
- 放射性药物疗法是一种放射性药物疗法.
背景情况:
- 对于转移性分化甲状腺癌 (mDTC) 的-131 (I-131) 的最佳累积活性 (CA) 正在争论中.
- 这项研究调查了最大的I-131 CA,而不会显著增加不良事件 (AE).
研究的目的:
- 在转移性分化甲状腺癌 (mDTC) 患者中确定-131 (I-131) 的最大可容忍累积活性 (CA).
- 评估I-131 CA与长期不良事件和生存结果之间的关联.
主要方法:
- 对671名接受I-131治疗的mDTC患者的回顾性分析,至少2年 (1967-2019) 的随访.
- 患者根据CA分为三组:≤600mCi (A组),>600-1000mCi (B组) 和>1000mCi (C组).
- 评估各组的长期不良事件和生存率.
主要成果:
- 十年生存率为72% (A组),42.7% (B组) 和29% (C组).
- 不良事件发生在1.1% (A组),5.7% (B组) 和13.2% (C组) 的患者中.
- 累积活性>1000mCi显著增加了骨髓抑制,肺功能下降和异位静脉 (P < .001).
结论:
- I-131的最大CA高达1000mCi,在最小化不良事件和提供治疗益处之间提供了有利的平衡.
- 这种剂量水平可能有利于选择的mDTC患者,这些患者有广泛的转移,表现出强烈的I-131吸收.
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