Therapy response and prognosis of different doses of <sup>131</sup>I for low- and intermediate-risk differentiated thyroid carcinoma

Zhang Jing; Chen Chang; Yang Yi; Zhang Bin

doi:10.13406/j.cnki.cyxb.003201

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Therapy response and prognosis of different doses of ¹³¹I for low- and intermediate-risk differentiated thyroid carcinoma

Clinical research | 更新时间：2025-10-21

- Therapy response and prognosis of different doses of ¹³¹I for low- and intermediate-risk differentiated thyroid carcinoma
- Journal of Chongqing Medical University Vol. 48, Issue 4, Pages: 444-449(2023)
- 作者机构：
  
  1.苏州大学附属第一医院核医学科，苏州 215006
  2.南京医科大学附属苏州科技城医院核医学科，苏州 215153
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003201
  CLC： R736.1
- Received：28 May 2022，
  
  Revised：2022-11-02，
  
  Accepted：03 January 2023，
  
  Published：28 April 2023
- 稿件说明：
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张静,陈畅,杨仪,等.不同剂量¹³¹I对中低危分化型甲状腺癌的疗效反应及预后分析[J].重庆医科大学学报,2023,48(4):444-449.

Zhang Jing,Chen Chang,Yang Yi,et al.Therapy response and prognosis of different doses of ¹³¹I for low- and intermediate-risk differentiated thyroid carcinoma[J].Journal of Chongqing Medical University,2023,48(4):444-449.
张静,陈畅,杨仪,等.不同剂量¹³¹I对中低危分化型甲状腺癌的疗效反应及预后分析[J].重庆医科大学学报,2023,48(4):444-449. DOI： 10.13406/j.cnki.cyxb.003201.

Zhang Jing,Chen Chang,Yang Yi,et al.Therapy response and prognosis of different doses of ¹³¹I for low- and intermediate-risk differentiated thyroid carcinoma[J].Journal of Chongqing Medical University,2023,48(4):444-449. DOI： 10.13406/j.cnki.cyxb.003201.

摘要

目的

探讨不同剂量

131

I对中低危分化型甲状腺癌（differentiated thyroid cancer，DTC）清除甲状腺组织（简称清甲）的疗效反应及无进展生存期（progression-free survival，PFS）有无差异。

方法

回顾性分析201例

131

I清甲治疗的DTC患者，共236人次接受

131

I治疗。根据治疗后6~12个月的血清学及影像学指标评估患者的疗效反应，根据

131

I治疗剂量分为1次1.1 GBq（G1组）、2次1.1 GBq（G2组）、3.0 GBq（G3组）和3.7 GBq（G4组）。对201例患者随访12~90个月，收集

131

I治疗后的血清学、影像学及治疗记录等资料，评估病情有无进展。卡方检验、Fisher确切概率法比较各治疗组的疗效差异及影响因素，Kaplan-Meier法及log-rank检验分析比较PFS，Cox比例风险模型评估PFS的独立预测因子。

结果

①4组的总疗效满意（excellent response，ER）、疗效不确切（indeterminate response，IDR）、血清学治疗反应不佳（biochemical incomplete response，BIR）和结构性治疗反应不佳（structural incomplete response，SIR）率分别为41.5%（98/236）、44.9%（106/236）、6.8%（16/236）

及6.8%（16/236）。②4组的ER率分别为16.67%（10/60）、42.86%（15/35）、56.52%（13/23）及50.85%（60/118）；IDR率分别为60.00%（36/60）、45.71%（16/35）、30.43%（7/23）及39.83%（47/118）；BIR率分别为10.00%（6/60）、0.00%（0/35）、4.35%（1/23）及7.63%（9/118）；SIR率分别为13.33%（8/60）、11.43%（4/35）、8.70%（2/23）及1.69%（2/118）。③G1组与G2~G4组的清甲疗效满意度（ER率）及G1组与G4组结构性疗效不佳（SIR率）差异有统计学意义（

=0.005、0.000、0.000、0.003）。④中位随访30个月，病情进展患者18例（8.96%）。不同剂量组的PFS差异无统计学差异（

=0.112）。年龄和疗效反应与PFS显著相关。

结论

对于中低危DTC患者，2次1.1 GBq与3.0 GBq及3.7 GBq

131

I的短期清甲效果无明显差异；不同剂量清甲治疗与PFS无明显相关，年龄

55岁和

131

I治疗反应为ER的患者PFS更优。

Abstract

Objective

To investigate therapy response and progression-free survival（PFS） with different doses of

131

I in postoperative patients with low- and intermediate-risk differentiated thyroid carcinoma（DTC）.

Methods

A total of 201 DTC patients with a total of 236 person-time

131

I treatments with different doses of

131

I were retrospectively analyzed. Serological and imaging indexes at 6 to 12 months after treatment were determined to evaluate the response of patients. And they were divided into four groups（G1 to G4 group） according to

131

I administered activity（1.1 GBq once，1.1 GBq twice，3.0 GBq，3.7 GBq）. The patients were followed up for 12 to 90 months，and their serological， imaging and treatment records were collected after

131

I therapy to assess the progression. Chi-square

test and Fisher’s exact test were performed to compare the differences in efficacy response and influencing factors among the treatment groups. Kaplan-Meier method and log-rank test were used to compare the PFS. Cox proportional risk model was used to evaluate the independent risk factors for PFS.

Results

①Total rate of excellent response（ER）/indeterminate response（IDR）/biochemical incomplete response（BIR）/structural incomplete res

ponse（SIR） among 4 groups were 41.5%（98/236），44.9%（106/236），6.8%（16/236） and 6.8%（16/236） respectively. ②The ER rates of G1 to G4 groups were 16.67%（10/60），42.86%（15/35），56.52%（13/23），and 50.85%（60/118）；the IDR rates of the four groups were 60.00% （36/60），45.71%（16/35），30.43%（7/23），and 39.83%（47/118）；the BIR rates of the four groups were 10.00%（6/60），0.00%（0/35），4.35%（1/23），and 7.63%（9/118）；the SIR rates of the four groups were 13.33%（8/60），11.43%（4/35），8.70%（2/23），and 1.69%（2/118） respectively. ③There was statistically significance in the rate of ER between G1 and G2/G3/G4（

0.005；0.000；0.000） and SIR between G1 and G4（

0.003）. ④The median follow-up time was 30 months，with progression observed in 18 patients（8.96%）. There were no significant differences in PFS among different doses of

131

I（

0.112）. Multivariate analysis showed that age and therapy response were independent prognostic factors for PFS.

Conclusion

The short-term ablation efficacy of

131

I between multiple low-dose（1.1 GBq twice） group and high-dose（3.0 and 3.7 GBq） groups has no significant difference in postoperative patients with low- and intermediate-risk DTC. Different doses of

131

I are not significantly related to PFS. For patients with ER and aged

55 years，there is a PFS benefit.

关键词

Keywords

references

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⁰

Therapy response and prognosis of different doses of 131I for low- and intermediate-risk differentiated thyroid carcinoma

DOI：10.13406/j.cnki.cyxb.003201

摘要

Abstract

关键词

Keywords

references

Therapy response and prognosis of different doses of ¹³¹I for low- and intermediate-risk differentiated thyroid carcinoma