分化型甲状腺癌放射性碘甲状腺残余消融治疗的治疗室住院时间和患者通量：促甲状腺激素刺激方法的比较

Treatment room length-of-stay and patient throughput with radioiodine thyroid remnant ablation in differentiated thyroid cancer: comparison of thyroid-stimulating hormone stimulation methods.

作者信息

Vallejo Casas Juan Antonio, Mena Bares Luisa M, Gálvez María Angeles, Marlowe Robert J, Latre Romero José M, Martínez-Paredes María

机构信息

Department of Nuclear Medicine, Reina Sofía University Hospital, Córdoba, Spain.

出版信息

Nucl Med Commun. 2011 Sep;32(9):840-6. doi: 10.1097/MNM.0b013e32834863b0.

DOI:10.1097/MNM.0b013e32834863b0

PMID:21691237

Abstract

OBJECTIVES

We sought to empirically compare treatment room length-of-stay and patient throughput for recombinant human thyroid-stimulating hormone (rhTSH)-aided thyroid remnant ablation with thyroid hormone withdrawal (THW)-aided ablation in patients with differentiated thyroid carcinoma (DTC).

METHODS

We retrospectively reviewed charts of all eligible (near) totally thyroidectomized patients with DTC undergoing ablation and 1-year ablation success evaluation at our tertiary referral centre from January 2003 to February 2009 (N=274). M1 disease caused exclusion unless discovered by a postablation scan or present when rhTSH was the only tolerable stimulation method. We extracted data on the length-of-stay, defined as the time between treatment room admission and discharge, and patient throughput, defined as patients ablated per treatment room per week. The treatment room discharge criterion was a whole-body dose rate of less than 60 μSv/h at 50 cm.

RESULTS

The treatment groups (rhTSH, n=187; THW, n=87) had mostly statistically similar characteristics, but differed in primary tumour status distribution. In addition, at ablation, the rhTSH patients had a greater prevalence of prior diagnostic scintigraphy, higher mean serum TSH, and shorter interval since surgery, and received a 5.6% larger mean ablation activity. On average, rhTSH patients had a significantly lower peak whole-body dose rate (57.1 vs. 83.4 μSv/h at 50 cm; P<0.0001) and a significantly shorter treatment room stay than did the THW patients (1.41 vs. 2.02 days; P<0.001). rhTSH use allowed significantly more patients to be ablated per room per week (2.7 vs. 1.2; P<0.001).

CONCLUSION

Relative to THW, rhTSH use to aid ablation reduced mean treatment room length-of-stay by almost one-third and more than doubled the average weekly patient throughput, both of which were significant differences.

摘要

目的

我们试图通过实证比较重组人促甲状腺激素（rhTSH）辅助甲状腺残余消融与甲状腺激素撤停（THW）辅助消融在分化型甲状腺癌（DTC）患者中的治疗室住院时间和患者通量。

方法

我们回顾性分析了2003年1月至2009年2月在我们的三级转诊中心接受消融及1年消融成功评估的所有符合条件的（近）全甲状腺切除的DTC患者的病历（N = 274）。除非在消融后扫描中发现或在rhTSH是唯一可耐受的刺激方法时存在，M1疾病导致排除。我们提取了住院时间的数据，定义为治疗室入院与出院之间的时间，以及患者通量，定义为每个治疗室每周消融的患者数量。治疗室出院标准是在50 cm处全身剂量率低于60 μSv/h。

结果

治疗组（rhTSH，n = 187；THW，n = 87）在大多数情况下具有统计学上相似的特征，但在原发肿瘤状态分布上有所不同。此外，在消融时，rhTSH患者先前诊断性闪烁扫描的患病率更高，平均血清TSH更高，手术间隔时间更短，并且接受的平均消融活度大5.6%。平均而言，rhTSH患者的全身剂量率峰值显著更低（50 cm处为57.1 vs. 83.4 μSv/h；P < 0.0001），并且治疗室停留时间明显短于THW患者（1.41 vs. 2.02天；P < 0.001）。使用rhTSH允许每个房间每周消融的患者明显更多（2.7 vs. 1.2；P < 0.001）。