| 范群 苏新辉 王卫星 苏福 匡安仁.13-顺式-维甲酸诱导再分化治疗甲状腺癌的前瞻性研究[J].,2015,15(34):6659-6663 |
| 13-顺式-维甲酸诱导再分化治疗甲状腺癌的前瞻性研究 |
| Redifferentiation Therapy with 13-CIS Retinoid Acid in DifferentiatedThyroid Carcinoma |
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| DOI： |
| 中文关键词: 13-顺式-维甲酸 诱导治疗 分化型甲状腺癌 |
| 英文关键词: 13-CRA Induction therapy Differentiated thyroid carcinoma |
| 基金项目:国家自然科学基金项目（81071182） |
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| 中文摘要: |
| 目的：13- 顺式- 维甲酸（13-CIS retinoid acid, 13-CRA）诱导再分化治疗131I- 诊断剂量全身显像（Diagnostic whole body scan,
dWBS）阴性且血清甲状腺球蛋白（Thyroglobulin, Tg）阳性（dWBS－Tg+）的分化型甲状腺癌（Differentiated thyroid carcinoma,
DTC）患者，评价其诱导效果及131I 治疗效果。方法：选择88例dWBS－Tg+ 的DTC 患者。根据实体瘤疗效评价标准（RECIST）对
13-CRA 诱导后再采用131I 治疗的效果进行评价，记录13-CRA 诱导期间出现的副作用。结果：80 例患者完成13-CRA诱导治疗，
其中49 例（61.25 %）诱导有效，31 例（38.75 %）无效。经13-CRA 诱导及131I 治疗后，完全缓解（CR）0 例，不完全缓解（IR）76 例
（95.00 %），病情进展（PD）4 例（5.00 %）。13-CRA 诱导后，131I- 治疗剂量全身显像（Therapic whole body scan, tWBS）的结果与治疗
效果呈显著的正相关关系，且相关关系密切（相关系数为0.644>0.5; P=0.000< 0.05）。13-CRA 诱导治疗过程中，出现的毒副反应主
要包括粘膜炎、唇炎、结膜炎、脱皮、脱发、胆固醇及转氨酶升高等。结论：13-CRA 诱导治疗能提高部分dWBS－Tg+ 的DTC 病灶
的摄碘功能，是治疗dWBS－Tg+ 的DTC 患者的一种有效方法。 |
| 英文摘要: |
| Objective:To evaluate the effectiveness of 13-CIS retinoid acid (13-CRA) for improving 131I uptake in
recurrent/metastasized differentiated thyroid carcinoma (DTC) with diagnostic 131I whole body scan (dWBS)-negative and Tg-positive
(dWBS－Tg+) and therapeutic effects in dWBS－ Tg+ - treated DTC patients with dWBS－Tg+ after 13-CRA induction.Methods:The
patients (n=88) of dWBS－Tg+ with DTC were given 13-CRA, followed by 131I treatment. The clinical outcome was classified and
evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST). The side-effects were documented according to the
common toxicity criteria (CTC) of the European Organization for the Treatment of Cancer (EORTC).Results:The patients (n=80)
finished 13-CRA induction therapy. There were 49 responders (61.25%) and 31 non-responders (38.75%) after 13-CRA induction. The
complete responder (CR) was 0, incomplete responder (IR) was 95.00% (76/80), and progressive disease (PD) was 5.00% (4/80). After
13-CRA induction, there was significantly positive correlation between tWBS and outcome (Spearman correlation coefficient was
0.644>0.5, P=0.000<0.05). The side effects including mucositis, cheilitis, desquamation, hair loss, pruritus, conjunctivitis and raised
transaminases occurred in most patients.Conclusion:13-CRA induction can increase 131I uptake in some recurrence/metastases, thus it
might be an option for advanced thyroid carcinoma and deserves further investigation. |
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