不同碘-131 剂量用于分化型甲状腺癌患者残余甲状腺消融的疗效比较：一项荟萃分析。

Different Radioiodine Dose for Remnant Thyroid Ablation in Patients With Differentiated Thyroid Cancer: A Meta-analysis.

机构信息

From the *Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin; †Department of Nuclear Medicine, Second Affiliated Hospital of Zhejiang Medical University, Hangzhou; ‡Department of Oncology, Tianjin Medical University General Hospital; and §Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenviroment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.

出版信息

Clin Nucl Med. 2015 Oct;40(10):774-9. doi: 10.1097/RLU.0000000000000914.

DOI:10.1097/RLU.0000000000000914

PMID:26204220

Abstract

OBJECTIVE

Remnant thyroid ablation is crucial in the management of patients with differentiated thyroid cancer. However, the optimal dose of radioactive I for ablation is still controversial. This study aimed to compare the success rate of different activities of I for postoperative remnant ablation in randomized controlled trials (RCTs) and to determine the optimal dose.

PATIENTS AND METHODS

Sources were retrieved from the Cochrane Library, Medline, Embase, Scopus, and Google Scholar until March 2014. All RCTs that assessed the efficacy of different doses of I for ablation were selected. After data extraction, statistics were performed by Review Manager 5.2 software.

RESULTS

Seventeen RCTs were considered eligible, involving 3737 patients. The overall methodological quality of the studies was good. The rate of successful remnant ablation of low versus moderate I activities (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.80-1.00; P = 0.06) and moderate versus high I activities (RR, 0.94; 95% CI, 0.89-1.00; P = 0.05) showed no significant differences. However, high I activities had 11% higher successful ablation rate than low activities with an RR of 0.89 (95% CI, 0.81-0.97; P = 0.008), which was significant.

CONCLUSIONS

We summarized all available randomized evidence to demonstrate that high dose of I was significantly better than low dose to achieve successful remnant thyroid ablation.

摘要

目的

甲状腺残留组织消融术在分化型甲状腺癌的治疗中至关重要。然而，放射性碘（I）消融的最佳剂量仍存在争议。本研究旨在比较不同 I 活度用于术后残留消融的随机对照试验（RCT）中的成功率，并确定最佳剂量。

方法

检索 Cochrane 图书馆、Medline、Embase、Scopus 和 Google Scholar 中的资料，检索时间截至 2014 年 3 月。所有评估不同剂量 I 消融疗效的 RCT 均被纳入。提取数据后，采用 Review Manager 5.2 软件进行统计分析。

结果

纳入 17 项 RCT，共 3737 例患者。研究的总体方法学质量较好。低活度 I 与中活度 I（风险比 [RR]，0.89；95%置信区间 [CI]，0.80-1.00；P = 0.06）以及中活度 I 与高活度 I（RR，0.94；95% CI，0.89-1.00；P = 0.05）之间的残留消融成功率差异均无统计学意义。然而，高活度 I 的成功率比低活度 I 高 11%，RR 为 0.89（95% CI，0.81-0.97；P = 0.008），差异有统计学意义。