Lu Liyan, Shan Fengling, Li Wenbin, Lu Hankui
Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.
Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.
Biomed Res Int. 2016;2016:4376720. doi: 10.1155/2016/4376720. Epub 2016 Feb 17.
I-131 therapy for differentiated thyroid cancer (DTC) could induce adverse effects. The purpose of this study was to report and analyze symptoms after I-131 treatment within the hospitalization and present relevant medical intervention.
I-131 doses ranging from 3.7 to 9.25 GBq (100-250 mCi) were administrated for thyroid remnant ablation or treating DTC metastases. 117 patients with DTC for I-131 therapy were monitored through the video and intercommunicating with standardized questionnaire at different time points after I-131 oral administration. Adverse effects were recorded and relevant clinical factors were analyzed.
Among all the 117 patients, 55 cases complained of neck's pain or swelling and 79 cases presented with gastrointestinal symptoms. Pain or swelling of salivary gland occurred in 15 patients, headache and vertigo in 10, insomnia in 9, vocal cord paralysis in 6, fatigue or general malaise in 6, and foreign body sensation in 5. Body numbness and urinary symptoms were observed in only 1 case, respectively. Those side effects were related with sex, pre-I-131 treatment TSH levels, frequency of I-131 therapy, and lymph node metastases.
Short-term side effects after I-131 therapy for DTC patients varied individually; severe symptoms were not uncommon but generally did not need emergent medical intervention.
I-131治疗分化型甲状腺癌（DTC）可能会引发不良反应。本研究旨在报告并分析I-131治疗后住院期间出现的症状，并提供相关医疗干预措施。
给予3.7至9.25 GBq（100 - 250 mCi）的I-131剂量用于甲状腺残余组织消融或治疗DTC转移灶。对117例接受I-131治疗的DTC患者在口服I-131后的不同时间点通过视频进行监测，并使用标准化问卷进行沟通。记录不良反应并分析相关临床因素。
在所有117例患者中，55例主诉颈部疼痛或肿胀，79例出现胃肠道症状。15例出现唾液腺疼痛或肿胀，10例出现头痛和眩晕，9例出现失眠，6例出现声带麻痹，6例出现疲劳或全身不适，5例出现异物感。仅各有1例出现身体麻木和泌尿系统症状。这些副作用与性别、I-131治疗前促甲状腺激素（TSH）水平、I-131治疗频率以及淋巴结转移有关。
I-131治疗DTC患者后的短期副作用因人而异；严重症状并不罕见，但一般不需要紧急医疗干预。
