分化型甲状腺癌患者术后放射性碘治疗
Postoperative radioactive iodine administration for differentiated thyroid cancer patients.
作者信息
Lepoutre-Lussey Charlotte, Deandreis Désirée, Leboulleux Sophie, Schlumberger Martin
机构信息
Gustave Roussy, University Paris Sud, Villejuif, Paris, France.
出版信息
Curr Opin Endocrinol Diabetes Obes. 2014 Oct;21(5):363-71. doi: 10.1097/MED.0000000000000100.
PURPOSE OF REVIEW
Radioactive iodine (RAI) is administered postoperatively to the majority of thyroid cancer patients. No available study has demonstrated any benefit in low-risk patients.
RECENT FINDINGS
RAI should be used selectively in low and intermediate-risk patients, based on the surgical and pathological reports and on postoperative serum thyroglobulin level and neck ultrasonography. When used, a low activity (30 mCi) is administered following recombinant human thyrotropin stimulation. High-risk patients are treated with a high activity of RAI (100 mCi or more).
SUMMARY
RAI is not administered in many low-risk patients who can be reliably followed up with serum thyroglobulin determination on L-thyroxine treatment and neck ultrasonography. RAI may be administered in case of abnormality, and this delay will not reduce the chance of cure.
综述目的
大多数甲状腺癌患者术后会接受放射性碘（RAI）治疗。目前尚无研究表明其对低风险患者有任何益处。
最新发现
应根据手术和病理报告、术后血清甲状腺球蛋白水平及颈部超声检查，对低风险和中风险患者选择性使用RAI。使用时，在重组人促甲状腺素刺激后给予低活度（30 mCi）的RAI。高风险患者接受高活度（100 mCi或更高）的RAI治疗。
总结
许多低风险患者在接受左甲状腺素治疗时通过血清甲状腺球蛋白测定及颈部超声检查能够得到可靠的随访，无需接受RAI治疗。如有异常情况可给予RAI治疗，这种延迟不会降低治愈几率。
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