| 摘要: |
| ［摘要］ 目的 对比分析单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT）与常规CT导引植入125I粒子对碘难治性甲状腺癌（RAIR-DTC）患者唾液腺功能、生存预后的影响。方法 选取2016年2月至2019年2月中南大学湘雅医学院附属常德医院（常德市第一人民医院）收治的116例RAIR-DTC患者，根据随机信封法将其分为观察组和对照组，各58例。对照组行常规CT导引植入125I粒子，观察组行SPECT-CT导引植入125I粒子。比较两组临床疗效、唾液腺功能、欧洲生命质量学会五维度健康量表（EQ-5D-5L）评分、不良反应发生率及治疗后5年内生存预后情况。结果 观察组疾病控制率显著高于对照组（P<0.05）。两组治疗后第3个月（T1）和治疗后第6个月（T2）腮腺最大浓聚率（MAR）、腮腺酸刺激后最大分泌率（MSR）、颌下腺MAR、颌下腺MSR显著低于治疗前（T0）（P<0.05）。T1、T2时间点观察组腮腺MAR、腮腺MSR、颌下腺MAR、颌下腺MSR显著高于对照组（P<0.05）。两组T1、T2时间点EQ-5D-5L评分显著高于T0时间点（P<0.05）。T1、T2时间点观察组EQ-5D-5L评分显著高于对照组（P<0.05）。观察组不良反应发生率显著低于对照组（P<0.05）。治疗后，观察组和对照组5年生存率分别为89.66%和75.86%。观察组生存预后显著优于对照组（log-rank检验： χ2=3.867，P=0.035）。结论 相比于常规CT导引植入125I粒子，SPECT-CT导引植入125I粒子治疗RAIR-DTC患者疗效确切，能有效改善患者唾液腺功能、生命质量和生存预后。 |
| 关键词: 唾液腺功能 预后 生存 单光子发射计算机断层扫描-计算机断层扫描 125I粒子 碘难治性甲状腺癌 |
| DOI：10.3969/j.issn.1674-3806.2025.09.17 |
| 分类号:R 736.1 |
| 基金项目:湖南创新型省份建设专项项目（编号：2025JJ80425） |
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| Comparison of effects of SPECT-CT and conventional CT-guided implantation of 125I seeds on salivary gland function and survival prognosis in patients with radioiodine-refractory differentiated thyroid cancer |
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YUAN Hui, RUAN Yi
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Department of Nuclear Medicine, Changde Hospital, Xiangya School of Medicine, Central South University(the First People′s Hospital of Changde City), Changde 415000, China
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| Abstract: |
| ［Abstract］ Objective To compare and analyze the effects of single-photon emission computed tomography-computed tomography(SPECT-CT) and conventional computed tomography(CT)-guided implantation of 125I seeds on salivary gland function and survival prognosis in patients with radioiodine-refractory differentiated thyroid cancer(RAIR-DTC). Methods A total of 116 patients with RAIR-DTC who were admitted to Changde Hospital, Xiangya School of Medicine, Central South University(the First People′s Hospital of Changde City) from February 2016 to February 2019 were selected and divided into observation group and control group according to random envelope method, with 58 patients in each group. The control group underwent conventional CT-guided implantation of 125I seeds, while the observation group underwent SPECT-CT-guided implantation of 125I seeds. The clinical efficacy, salivary gland function, European Quality of Life Five-Dimension Five-Level Scale(EQ-5D-5L) scores, incidence of adverse reactions and survival prognosis within 5 years after treatment were compared between the two groups. Results The disease control rate of the observation group was significantly higher than that of the control group(P<0.05). At 3 months(T1) and 6 months(T2) after treatment, the maximum concentration rate(MAR) of the parotid gland, the maximum secretion rate(MSR) of the parotid gland after acid stimulation, the MAR of the submandibular gland, and the MSR of the submandibular gland were significantly lower than those before treatment(T0) in the two groups(P<0.05). At the time points of T1 and T2, the MAR of the parotid gland, the MSR of the parotid gland, the MAR of the submandibular gland, and the MSR of the submandibular gland in the observation group were significantly higher than those in the control group(P<0.05). The EQ-5D-5L scores in the two groups at the time points of T1 and T2 were significantly higher than those at the time point of T0(P<0.05). The EQ-5D-5L scores at the time points of T1 and T2 in the observation group were significantly higher than those in the control group(P<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05). After the treatment, the 5-year survival rate was 89.66% in the observation group, and 75.86% in the control group. The survival prognosis of the observation group was significantly better than that of the control group(log-rank test: χ2=3.867, P=0.035). Conclusion Compared with conventional CT-guided implantation of 125I seeds, SPECT-CT-guided implantation of 125I seeds has a definite therapeutic effect in treatment of patients with RAIR-DTC. The SPECT-CT-guided implantation of 125I seeds can effectively improve the salivary gland function, quality of life and survival prognosis of the patients. |
| Key words: Salivary gland function Prognosis Survival Single-photon emission computed tomography-computed tomography(SPECT-CT) 125I seeds Radioiodine-refractory differentiated thyroid cancer(RAIR-DTC) |
