ABSTRACT
Objective To investigate the clinical effect of 125I seeds implantation on bone metastasis from radioactive iodine-refractory differentiated thyroid carcinoma (RAIR-DTC).Methods A total of 9 RAIR-DTC patients with bone metastases (4 males,5 females,age range:42-87 years) between April 2014 and December 2016 were enrolled in this prospective study.Treatment plan was developed through treatment planning system (TPS).125I seeds implantation was performed under CT guidance.After 2 and 4 months,metastasis size,serum thyroglobulin (Tg) and verbal rating scale (VRS) pain score changes were recorded.Paired t test and two-sample t test were used for data analysis.Results VRS pain score decreased 2 months post-treatment comparing with that before treatment (2.56±0.88 vs 5.22±2.44;t =4.28,P＜0.01).VRS pain score at 4 months post-treatment was 1.78±0.83,which was lower than that at 2 months post-treatment (t =3.48,P＜0.01).The maximum tumor diameters before the implantation and 2 months post-treatment were (6.47± 1.84) cm and (5.08±2.11) cm,respectively (t =9.14,P＜0.01).The maximum tumor diameter at 4 months post-treatment showed a decreasing trend but it was not statistically different compared to that at 2 months post-treatment:((4.52±2.16) cm;t =2.19,P＞0.05).Serum Tg level reduced 2 months after the implantation (lgTg:2.71±0.85 vs 2.94±0.82;t =4.82,P＜0.01).Serum Tg level at 4 months post-treatment (lgTg:2.56±0.81) was lower than that at 2 months post-treatment (t =2.69,P＜0.05).Conclusions 125I seeds implantation is an effective method for treating bone metastasis from RAIR-DTC.It can help to shrink bone metastasis,alleviate pain and improve patients' quality of life.
ABSTRACT
Objective To observe the serum levels of calcium, phosphorus, alkaline phosphatase (ALP), parathy-roid hormone (PTH) and 25-hydroxyvitamin D, and the influence of biochemical markers of bone turnover in Graves’dis-ease. Methods Sixty-two patients with Graves’disease were enrolled into the Graves’disease group and 91 healthy indi-viduals as a control group. Electrochemical luminescence was used to evaluate the plasma levels of PTH and 25-hydroxyvita-min D in two groups. The serum levels of calcium, phosphorus and ALP were measured with biochemistry methods in two groups. Results The serum levels of calcium, phosphorus, ALP and 25-hydroxyvitamin D were significantly higher in the Graves’disease group compared with those in control group (P<0.01). The serum levels of calcium, phosphorus, ALP and 25-hydroxyvitamin D were significantly higher in female patients than those of control group, and the level of PTH was lower than that of control group. For male patients, the levels of ALP and 25-hydroxyvitamin D were higher than those of control group, and the level of PTH was lower than that of control group. In Graves’disease group, patients with vitamin D deficien-cy were 17 cases (27.4%), insufficiency 20 cases (32.3%) and sufficiency 25 cases (40.3%), respectively. In control group, there were 54 cases with vitamin D deficiency (59.3%), 31 cases with insufficiency vitamin D (34.1%) and 6 cases with suffi-ciency vitamin D (6.6%), respectively. There was no correlation in plasma levels of PTH, 25-hydroxyvitamin D, serum calci-um and serum phosphorus in Graves’disease group. Conclusion The bone turnover is accelerated in Graves’disease. The increased plasma level of 25-hydroxyvitamin D is related with increased calcium level and decreased PTH level in Graves’ disease. The increased serum phosphorus reduces 1-α-hydroxylase activity. Vitamin D deficiency plays a minor role in bone metabolism of Graves’disease.