ISSN: 1859 - 2872
Hiệu quả điều trị của I-131 liều thấp ở bệnh nhân ung thư tuyến giáp thể biệt hóa đã phẫu thuật tại Bệnh viện K
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Keywords
Ung thư tuyến giáp, I-131, xóa mô giáp
Tóm tắt
Mục tiêu: Đánh giá hiệu quả của I-131 liều thấp 30mCi (điều trị ngoại trú) xóa mô giáp còn lại ở bệnh nhân ung thư tuyến giáp thể biệt hóa nguy cơ thấp sau phẫu thuật cắt toàn bộ tuyến giáp ở Bệnh viện K. Đối tượng và phương pháp: Nghiên cứu hồi cứu trên 150 bệnh nhân điều trị với liều 30mCi I-131 từ tháng 01/2020 đến tháng 6/2021. Kết quả: Nghiên cứu có 139 bệnh nhân nữ (93,7%), 11 bệnh nhân nam (7,3%), tuổi từ 27 đến 74, trung bình 51 ± 10 tuổi; 89 bệnh nhân (59,3%) < 55 tuổi, 61 bệnh nhân (40,7%) trên 55 tuổi. Tỉ lệ xóa mô tuyến giáp thành công ở 120 bệnh nhân (80%), thyroglobulin huyết thanh trước điều trị là 2,33 ± 7,07ng/ml, sau điều trị là 1,20 ± 6,77, mức giảm thyroglobulin huyết thanh trước và sau điều trị có ý nghĩa thống kê với p=0,006. Kết luận: Liều 30mCi I-131 có hiệu quả tốt trong việc xóa bỏ mô tuyến giáp còn lại sau phẫu thuật cho những bệnh nhân có yếu tố nguy cơ thấp.
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Các tài liệu tham khảo
1. Vardarli I, Weidemann F, Aboukoura M, Herrmann K, Binse I, Görges R (2020) Longer-term recurrence rate after low versus high dose radioiodine ablation for differentiated thyroid Cancer in low and intermediate risk patients: A meta-analysis. BMC Cancer 20: 550. https://doi.org/10.1186/s12885-020-07029-3.
2. Li F, Li W, Gray KD, Zarnegar R, Wang D, Fahey TJ 3rd (2020) Ablation therapy using a low dose of radioiodine may be sufficient in low-to intermediate-risk patients with follicular variant papillary thyroid carcinoma. DOI: 10.1177/0300060520966491.
3. Chung SR, Baek JH, Choi YJ, Lee JH (2019) Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. European Society of Radiology. https://doi.org/10.1007/s00330-019-06063-5.
4. Jeong SY, Lee SW, Kim WW et al (2019) Clinical outcomes of patients with T4 or N1b well-differentiated thyroid cancer after different strategies of adjuvant radioiodine therapy. Scientific Reports 9:5570. https://doi.org/10.1038/s41598-019-42083-3.
5. Jimenez Londoño GA, Garcia Vicente AM, Sastre Marcos J, Pena Pardo FJ, Amo-Salas M, Moreno Caballero M, Talavera Rubio MP, Gonzalez Garcia B, Disotuar Ruiz ND, Soriano Castrejón AM (2018) Low-dose radioiodine ablation in patients with low-risk differentiated thyroid cancer. European Thyroid Association, DOI: 10.1159/000489850.
6. Peiris AN, Medlock D, Gavin M (2019) Thyroglobulin for monitoring for thyroid cancer recurrence. JAMA 321(12): 1228. doi:10.1001/jama.2019.0803.
7. Indrasena BS (2017) Use of thyroglobulin as a tumour marker. World J Biol Chem 8(1): 81-85.
8. Lv RB, Wang QG, Liu C, Liu F, Zhao Q, Han JG, Ren DL, Liu B, Li CL (2017) Low versus high radioiodine activity for ablation of the thyroid remnant after thyroidectomy in Han Chinese with low-risk differentiated thyroid cancer. OncoTargets and Therapy 10: 4051-4057.
9. Wagieh Sh, Al Salman Kh, Munshy T, El Refaei Sh, Abd- El Kareem M, and Abd-El Razek Sh (2012) Successful complete ablation rate post a second ablation dose of 30mCi radioactive Iodine (I-131) in patients with papillary thyroid cancer. Egyptian J. Nucl. Med 5(1).
10. Ibrahim DR, Kelany MR, Michael MM, and Elsayed ZM (2016) Low-dose versus high-dose radioactive iodine ablation of differentiated thyroid carcinoma: A prospective randomized study. International Journal of Cancer Therapy and Oncology, December.
11. Yasmin T, Adnan S, Younis MN, Fatima A, Shahid A (2021) Comparing high and low-dose radio-iodine therapy in thyroid remnant ablation among intermediate and low-risk papillary thyroid carcinoma patients single centre experience. Dose-response: An international journal: 1-7.
12. Mazzaferri EL, Robbins RJ, Spencer CA, Braverman LE, Pacini F, Wartofsky L, Haugen BR, Sherman SI, Cooper DS, Braunstein GD, Lee S, Davies TF, Arafah BM, Ladenson PW, Pinchera A (2003) A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma. The Journal of Clinical Endocrinology & Metabolism 88(4): 1433-1441. doi: 10.1210/ jc.2002-021702.
13. Couto JS, Almeida MFO, Trindade VCG, Marone MMS, Scalissi NM, Cury AN, Ferraz C, Padovani RP (2020) A cutoff thyroglobulin value suggestive of distant metastases in differentiated thyroid cancer patients. Brazilian Journal of Medical and Biological Research 53(11): 9781
2. Li F, Li W, Gray KD, Zarnegar R, Wang D, Fahey TJ 3rd (2020) Ablation therapy using a low dose of radioiodine may be sufficient in low-to intermediate-risk patients with follicular variant papillary thyroid carcinoma. DOI: 10.1177/0300060520966491.
3. Chung SR, Baek JH, Choi YJ, Lee JH (2019) Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. European Society of Radiology. https://doi.org/10.1007/s00330-019-06063-5.
4. Jeong SY, Lee SW, Kim WW et al (2019) Clinical outcomes of patients with T4 or N1b well-differentiated thyroid cancer after different strategies of adjuvant radioiodine therapy. Scientific Reports 9:5570. https://doi.org/10.1038/s41598-019-42083-3.
5. Jimenez Londoño GA, Garcia Vicente AM, Sastre Marcos J, Pena Pardo FJ, Amo-Salas M, Moreno Caballero M, Talavera Rubio MP, Gonzalez Garcia B, Disotuar Ruiz ND, Soriano Castrejón AM (2018) Low-dose radioiodine ablation in patients with low-risk differentiated thyroid cancer. European Thyroid Association, DOI: 10.1159/000489850.
6. Peiris AN, Medlock D, Gavin M (2019) Thyroglobulin for monitoring for thyroid cancer recurrence. JAMA 321(12): 1228. doi:10.1001/jama.2019.0803.
7. Indrasena BS (2017) Use of thyroglobulin as a tumour marker. World J Biol Chem 8(1): 81-85.
8. Lv RB, Wang QG, Liu C, Liu F, Zhao Q, Han JG, Ren DL, Liu B, Li CL (2017) Low versus high radioiodine activity for ablation of the thyroid remnant after thyroidectomy in Han Chinese with low-risk differentiated thyroid cancer. OncoTargets and Therapy 10: 4051-4057.
9. Wagieh Sh, Al Salman Kh, Munshy T, El Refaei Sh, Abd- El Kareem M, and Abd-El Razek Sh (2012) Successful complete ablation rate post a second ablation dose of 30mCi radioactive Iodine (I-131) in patients with papillary thyroid cancer. Egyptian J. Nucl. Med 5(1).
10. Ibrahim DR, Kelany MR, Michael MM, and Elsayed ZM (2016) Low-dose versus high-dose radioactive iodine ablation of differentiated thyroid carcinoma: A prospective randomized study. International Journal of Cancer Therapy and Oncology, December.
11. Yasmin T, Adnan S, Younis MN, Fatima A, Shahid A (2021) Comparing high and low-dose radio-iodine therapy in thyroid remnant ablation among intermediate and low-risk papillary thyroid carcinoma patients single centre experience. Dose-response: An international journal: 1-7.
12. Mazzaferri EL, Robbins RJ, Spencer CA, Braverman LE, Pacini F, Wartofsky L, Haugen BR, Sherman SI, Cooper DS, Braunstein GD, Lee S, Davies TF, Arafah BM, Ladenson PW, Pinchera A (2003) A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma. The Journal of Clinical Endocrinology & Metabolism 88(4): 1433-1441. doi: 10.1210/ jc.2002-021702.
13. Couto JS, Almeida MFO, Trindade VCG, Marone MMS, Scalissi NM, Cury AN, Ferraz C, Padovani RP (2020) A cutoff thyroglobulin value suggestive of distant metastases in differentiated thyroid cancer patients. Brazilian Journal of Medical and Biological Research 53(11): 9781
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BìnhD. Đức, TânN. T., VănN. Q., & SơnP. L. (2023). Hiệu quả điều trị của I-131 liều thấp ở bệnh nhân ung thư tuyến giáp thể biệt hóa đã phẫu thuật tại Bệnh viện K. Journal of 108 - Clinical Medicine and Phamarcy, 18(YHHN). https://doi.org/10.52389/ydls.v18iYHHN.1921