Pulmonary metastases in differentiated thyroid cancer: efficacy of radioiodine therapy and prognostic factors
Pulmonary metastases in differentiated thyroid cancer: efficacy of radioiodine therapy and prognostic factors
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分化型甲状腺癌肺转移：放射性碘治疗的疗效和预后因素
DOI：
10.1530/eje-15-0296
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发表时间：
2015-09-01
影响因子：
5.8
通讯作者：
Luo, Quan-Yong
中科院分区：
文献类型：
--
作者：
Song, Hong-Jun;Qiu, Zhong-Ling;Luo, Quan-Yong
内容：回顾性分析372例分化型甲状腺癌（DTC）肺转移患者的临床资料，探讨13 I治疗DTC肺转移的疗效及影响预后的因素。根据I-131全身扫描（WBS）结果，将肺转移瘤分为I-131-avid和非I-131-avid。对于I-131-avid肺转移患者，通过三个参数测量治疗反应：血清甲状腺球蛋白（Tg）水平、胸部计算机断层扫描（CT）和治疗后I-131-WBS。采用Kaplan-Meier法计算总生存期。通过多变量分析确定预后的预测因素。在显示I-131亲合性肺转移的患者中（256/372，68.8%），156例156例（60.9%）患者在I-131治疗后血清Tg水平显著下降，（138/229，60.3%）在随访CT中显示肺转移灶减少。然而，仅62例（62/256，24.2%）完全治愈。多因素分析显示，年龄、是否存在多发远处转移和肺转移淋巴结大小是I-131-avid组与非I-131-avid组间差异有统计学意义的自变量。结论：I-131-avid的DTC肺转移瘤经I-131治疗后，大多数可获得部分或完全缓解。年轻的患者（
Context: Data from a large cohort of patients with pulmonary metastases from differentiated thyroid cancer (DTC) were retrospectively analyzed.Objective: To assess the effect of radioiodine therapy and investigate the prognostic factors of survival for patients with pulmonary metastasis secondary to DTC.Methods: A total of 372 patients with pulmonary metastasis from DTC treated with I-131 entered the study. According to the results of I-131 whole-body scan (WBS), pulmonary metastases were classified as I-131-avid and non-I-131-avid. For patients with I-131-avid lung metastases, treatment response was measured by three parameters: serum thyroglobulin (Tg) levels, chest computed tomography (CT) and post-therapeutic I-131-WBS. Overall survival was calculated by the Kaplan-Meier method. Factors predictive of the outcome were determined by multivariate analyses.Results: Among patients demonstrating I-131-avid pulmonary metastases (256/372, 68.8%), 156 cases (156/256, 60.9%) showed a significant decrease in serum Tg levels after I-131 therapy and 138 cases (138/229, 60.3%) showed a reduction in pulmonary metastases on follow-up CT. A complete cure, however, was only achieved in 62 cases (62/256, 24.2%). Multivariate analysis showed that only age, the presence of multiple distant metastases and pulmonary metastatic node size were significant independent variables between the groups of I-131-avid and non-I-131-avid.Conclusion: This study indicated that, most I-131-avid pulmonary metastases from DTC can obtain partial or complete remission after I-131 therapy. Younger patients (