论文部分内容阅读
目的:探讨不同放射剂量对甲状腺癌术后残余癌的疗效及对患者淋巴细胞亚群的影响。方法:选取2010年1月—2015年1月收治的未分化型甲状腺癌术后残余癌患者90例,根据放射剂量分为高剂量组(46例)和低剂量组(44例),高剂量组给予50~75 Gy放射剂量,低剂量组给予45~49 Gy放射剂量,随访两组转移情况及生存率,检测治疗前后淋巴细胞亚群比例。结果:高剂量组随访期间淋巴转移和纵膈转移发生率为10.87%和8.70%,明显低于低剂量组的29.55%和25.00%(均P<0.05),但两组骨转移和脑转移发生率(6.52%vs.11.36%;4.35%vs.9.09%)比较差异无统计学意义(均P>0.05);高剂量组治疗后1周CD4+、NK细胞和B细胞明显低于低剂量组,而CD8+明显高于低剂量组(均P<0.05);高剂量组与低剂量组治疗后1、3个月CD4+、CD8+、NK细胞和B细胞比较,差异无统计学意义(P>0.05);高剂量组1、2、3年生存率分别为100.00%、93.00%、77.30%,低剂量组分别为95.20%、83.00%、30.80%,组间比较均有统计学意义(均P<0.05)。结论:未分化型甲状腺癌术后残余癌应用50~75 Gy放射剂量效果较好,能减少术后转移,提高患者生存率,对患者淋巴细胞亚群有一定程度影响,但可较快恢复。
Objective: To investigate the effect of different doses of radiation on postoperative residual cancer of thyroid cancer and the effect on lymphocyte subsets. Methods: 90 patients with residual cancer of undifferentiated thyroid cancer who were admitted from January 2010 to January 2015 were divided into high dose group (46 cases) and low dose group (44 cases) according to radiation dose. High dose Radiotherapy dose of 50 Gy to 75 Gy was given in group A, and 45 Gy to 49 Gy was given in low dose group. The metastasis and survival rate of the two groups were followed up. The proportion of lymphocyte subsets was measured before and after treatment. Results: The incidence of lymphatic metastasis and mediastinum metastasis in high-dose group was 10.87% and 8.70%, significantly lower than that of low-dose group (29.55% vs 25.00%, P <0.05), but bone metastasis and brain metastasis The rates of CD4 +, NK cells and B cells in high dose group were significantly lower than those in low dose group at 1 week after treatment (6.52% vs.11.36%; 4.35% vs.9.09%, respectively) (P <0.05). There was no significant difference in CD4 +, CD8 +, NK cells and B cells between high-dose group and low-dose group at 1 and 3 months after treatment (P> 0.05) ; The 1, 2, 3-year survival rates were 100.00%, 93.00% and 77.30% in the high-dose group and 95.20%, 83.00% and 30.80% in the low-dose group ). CONCLUSION: Radiotherapy dose of 50-75 Gy in patients with undifferentiated thyroid carcinoma after operation is better than radiotherapy. It can reduce the postoperative metastasis and improve the survival rate of patients with lymphocyte subsets to a certain extent, but can recover quickly.