Endocr Pract. 2016 Sep;22(9):1048-56. doi: 10.4158/EP151139.OR. Epub 2016 Apr 28.
Prognostic factors related to progression-free survival (PFS) have not received much attention in the literature regarding iodine-131 ((131)I) therapy for patients with differentiated thyroid cancer and lung metastases. We sought to explore the factors associated with PFS and nonremission in a group of patients with differentiated thyroid cancer and pulmonary metastases at initial diagnosis and to investigate the impact of (131)I therapy on pulmonary function and peripheral blood counts in the same cohort of patients.
The medical records of 1,050 patients with differentiated thyroid cancer treated at the Zhujiang Hospital of Southern Medical University from January 2006 to January 2015 were retrospectively reviewed. Among them, 107 patients fulfilled the inclusion criteria.
Multivariate Cox regression analysis indicated that age ≥45 years and (131)I nonavidity were independent risk factors for disease progression. Multivariate logistic regression analysis revealed that pulmonary nodule size ≥1 cm and (131)I nonavidity were the strongest risk factors predicting nonremission. Varying cumulative (131)I dosage had no association with posttreatment pulmonary function or peripheral blood cell counts.
Similar to earlier studies, our results confirm that (131)I nonavidity was associated with an increased risk of disease progression and greater odds of nonremission. In addition, patients with differentiated thyroid cancer and lung metastases with pulmonary nodules ≥1 cm had a reduced likelihood of achieving remission. Furthermore, special attention is needed when monitoring patients over 45 years at a higher risk of disease progression.
CI = confidence interval DTC = differentiated thyroid cancer (18)F-FDG = fluoro-18 fluorodeoxyglucose FEF = forced expiratory flow FTC = follicular thyroid cancer FVC = forced vital capacity GR = granulocytes Hb = hemoglobin HR = hazard ratio (131)I = iodine-131 LN = lymph node OR = odds ratio OS = overall survival PET/CT = positive positron emission tomography/computed tomography PFS = progression-free survival PT = partial thyroidectomy PTC = papillary thyroid cancer RAI = radioactive iodine RBC = red blood cell Tg = thyroglobulin TgAb = thyroglobulin antibody TSH = thyroid-stimulating hormone TT = total thyroidectomy WBC = white blood cells WBS = whole body scan.
关于碘-131((131)I)治疗分化型甲状腺癌伴肺转移患者，无进展生存期(PFS)的预后因素尚未得到太多关注。我们旨在探讨一组初诊时分化型甲状腺癌伴肺转移患者的 PFS 和未缓解的相关因素，并研究同一批患者中(131)I 治疗对肺功能和外周血细胞计数的影响。
回顾性分析 2006 年 1 月至 2015 年 1 月南方医科大学珠江医院收治的 1050 例分化型甲状腺癌患者的病历资料，其中 107 例符合纳入标准。
多变量 Cox 回归分析表明，年龄≥45 岁和(131)I 无摄取是疾病进展的独立危险因素。多变量 logistic 回归分析显示，肺结节大小≥1cm 和(131)I 无摄取是预测未缓解的最强危险因素。不同累积(131)I 剂量与治疗后肺功能或外周血细胞计数无关。
与早期研究类似，我们的结果证实(131)I 无摄取与疾病进展风险增加和未缓解的可能性增加相关。此外，肺转移灶≥1cm 的分化型甲状腺癌患者缓解的可能性降低。此外，对于疾病进展风险较高的 45 岁以上患者，需要特别注意监测。
CI = 置信区间；DTC = 分化型甲状腺癌；(18)F-FDG = 氟-18 氟代脱氧葡萄糖；FEF = 用力呼气流量；FTC = 滤泡性甲状腺癌；FVC = 用力肺活量；GR = 粒细胞；Hb = 血红蛋白；HR = 风险比；(131)I = 碘-131；LN = 淋巴结；OR = 比值比；OS = 总生存期；PET/CT = 正电子发射断层扫描/计算机断层扫描；PFS = 无进展生存期；PT = 部分甲状腺切除术；PTC = 甲状腺乳头状癌；RAI = 放射性碘；RBC = 红细胞；Tg = 甲状腺球蛋白；TgAb = 甲状腺球蛋白抗体；TSH = 促甲状腺激素；TT = 全甲状腺切除术；WBC = 白细胞；WBS = 全身扫描。
