Bhagat J K, Prasad Brig Dinesh
Classified Specialist (Nuclear Medicine), INHS Asvini, Colaba, Mumbai 400005.
Consultant (Medicine). Army Hospital (R & R), Delhi Cantt 110 010.
Med J Armed Forces India. 1998 Jan;54(1):38-40. doi: 10.1016/S0377-1237(17)30405-7. Epub 2017 Jun 26.
During last 17 years, 175 patients of carcinoma thyroid were treated in this centre. Hundred patients (57%) of papillary carcinoma formed majority. Fifty four patients (31%) were follicular carcinoma and 15 (8.5%) were mixed variety. Two (1.3%) were medullary carcinoma, 3 (1.7%) anaplastic type and 1 (0.5%) hurthle cell carcinoma. After surgery these patients were assessed for radio iodine uptake, residual thyroid tissue and distant metastasis which determined the dose of radioiodine for ablation. Fifty two per cent (91) patients presented as multi nodular goitre, 22.3 per cent (39) as solitary nodule, 13.7 per cent (24) had lymph node metastasis, 5.7 per cent (10) bone metastasis, 2.5 per cent (4) had lung metastasis and 3.8 per cent (7) presented as thyrotoxicosis. Average number of therapy for complete ablation in papillary carcinoma was 1.5, follicular 1.78 and mixed variety 1.5. 72.6 per cent cases (127) needed single dose for ablation, 14.9 per cent (26) needed 2 doses and 5.7 per cent (10) required 3 doses. Only 6.8 per cent (12) cases needed 4 to 8 doses. Average dose of I administered for ablation was 157 mci in males and 124 mci in females of papillary carcinoma thyroid. Males in follicular variety required 204 mci and females needed only 120 mci. In mixed variety males required 177 mci and females required 62.5 mci for complete ablation. 144 patients (82.3%) were followed up to 5 years and remaining patients from 6 to 17 years. These patients are followed up once in a year or alternate years. Follow-up and medical record keeping for defence personnel is done with meticulous care, therefore followup results are very encouraging.
在过去的17年里，该中心共治疗了175例甲状腺癌患者。其中乳头状癌患者100例（57%）占大多数。滤泡状癌患者54例（31%），混合性癌患者15例（8.5%）。髓样癌2例（1.3%），未分化型3例（1.7%），嗜酸性细胞癌1例（0.5%）。手术后，对这些患者进行放射性碘摄取、残余甲状腺组织和远处转移情况的评估，以确定消融所需的放射性碘剂量。52%（91例）患者表现为多结节性甲状腺肿，22.3%（39例）为孤立结节，13.7%（24例）有淋巴结转移，5.7%（10例）有骨转移，2.5%（4例）有肺转移，3.8%（7例）表现为甲状腺毒症。乳头状癌完全消融的平均治疗次数为1.5次，滤泡状癌为1.78次，混合性癌为1.5次。72.6%（127例）的病例消融需要单剂量，14.9%（26例）需要2剂，5.7%（10例）需要3剂。只有6.8%（12例）的病例需要4至8剂。甲状腺乳头状癌男性消融时给予的碘平均剂量为157毫居里，女性为124毫居里。滤泡状癌男性需要204毫居里，女性仅需120毫居里。混合性癌男性完全消融需要177毫居里，女性需要62.5毫居里。144例患者（82.3%）随访了5年，其余患者随访了6至17年。这些患者每年或每隔一年随访一次。对国防人员的随访和病历记录非常仔细，因此随访结果非常令人鼓舞。
