IS IT STILL WORTHWHILE TO TREAT BONE METASTASES FROM DIFFERENTIATED THYROID-CARCINOMA WITH RADIOACTIVE IODINE
IS IT STILL WORTHWHILE TO TREAT BONE METASTASES FROM DIFFERENTIATED THYROID-CARCINOMA WITH RADIOACTIVE IODINE
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DOI：
10.1007/bf02067343
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发表时间：
1992-07-01
影响因子：
2.6
通讯作者：
SULMAN, C
中科院分区：
文献类型：
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作者：
PROYE, CAG;DROMER, DHR;SULMAN, C
从1964年至1989年，在600例分化型甲状腺癌手术患者中发现28例骨转移。 骨转移是15例（54%）患者的主要症状，4例（14.5%）患者在最初症状时发现，9例（32%）患者随后发生，平均延迟时间为手术治疗后4.5年。 甲状腺癌的病理类型为滤泡状26例（93%），乳头状2例（7%）。 多发性骨转移21例（75%），13例（46%）伴有其他同时性或异时性远处转移，尤其是肺转移（10例）或脑转移（3例）。 所有15例出现症状的患者均经X线检查证实有骨转移。 6例骨转移瘤仅在甲状腺全切除术后6周摄取放射性碘，4例骨转移瘤中有2例在初始观察时检出，9例异时性骨转移瘤中有4例。 所有12例功能性骨转移瘤患者均给予放射性碘治疗，其中4例转移瘤手术切除。 只有2例骨转移患者在I-131消融剂量后表现出完全反应; X线检查未发现转移灶。放射性碘治疗治愈骨转移患者的放射性碘摄入量不超过17%，治愈骨转移患者的放射性碘摄入量不超过7%。 所有骨转移治愈的患者均给予放射性碘，单独或联合其他治疗。 骨转移，当明显的x线检查，从来没有消失后，放射性碘治疗单独。
From 1964 to 1989, bone metastases were found in 28 of 600 patients operated on for differentiated thyroid carcinoma. Bone metastasis was the presenting symptom in 15 (54%) patients, was detected from the initial symptom in 4 (14.5%) patients, and occurred subsequently in 9 (32%) patients, with an average lag time of 4.5 years after surgical treatment. Pathological pattern of the thyroid cancer was follicular in 26 (93%) patients and papillary in 2 (7%) patients. Bone metastatic involvement was multiple in 21 (75%) patients and associated with other synchronous or metachronous distant metastases in 13 (46%) patients, especially in the lung (10 patients) or the brain (3 patients).The primary treatment of thyroid carcinoma was total thyroidectomy in all 28 patients, with additional modified neck dissection in 8 patients. All 15 patients presenting with symptoms had bone metastases demonstrated by x-ray studies. Six of the bone metastases only took up radioactive iodine 6 weeks after total thyroidectomy, as did 2 of 4 bone metastases detected at initial observation and 4 of 9 metachronous bone metastases. All 12 patients with functioning bone metastases were given radioactive iodine therapy; 4 of the metastases were surgically resected. Only 2 patients with bone metastases showed a complete response after an ablative dose of I-131; none of the metastases had been demonstrated by x-ray studies.Radiactive iodine therapy cures no more than 17% of patients with bone metastases taking up radioactive iodine and 7% of all patients with bone metastases. All patients cured of bone metastases were given radioactive iodine, either alone, or combined with other treatment. Bone metastases, when evident on x-ray examination, never disappear after radioactive iodine therapy alone.