Comparison of therapeutic effects of different methods on stage Ⅳ differentiated thyroid cancer / 中国基层医药

ABSTRACT

Objective To investigate the effect of different treatment methods on the survival of patients with stage Ⅳ differentiated thyroid cancer (DTC).Methods From January 2013 to June 2015,90 patients with stage Ⅳ DTC in the Second Hospital of Shanxi Medical University were randomly divided into three groups according to the digital table,A,B and C group,with 30 cases in each group.The patients in A group were treated with surgery combined with 131 I,and the patients in B group were treated with surgery combined with TSH inhibition,and the patients in C group were treated with operation combined with 131I + TSH inhibition.The therapeutic effect,postoperative quality of life score and short-term and long-term survival rate were evaluated.Results After treatment,the levels of Tg in A group [(25.06 ± 3.41)μg/L] and C group [(24.89 ± 3.27)μg/L] were significantly lower than that in B group [(45.46 ± 3.58) μg/L],and the levels of TSH in B group [(0.36 ± 0.26) mU/L] and C group [(0.36 ± 0.18)mU/L] were significantly lower than that in A group [(0.67 ± 0.31)mU/L] (t =3.624,3.337,3.289,3.667,all P ＜0.05).The success rates of nail clearance in A group and C group were 50.00％ (15/30) and 56.67％ (17/30),respectively,which were significantly higher than 33.33％ (10/30) in B group (x2 =3.475,4.967,all P ＜ 0.05).The postoperative quality of life (GQOL[-74) scores among the three groups had statistically significant differences (F =4.354,5.216,4.672,5.197,all P ＜ 0.05).The 1-year (80.00％),2-year (53.33％) and 3-year (33.33％) survival rates in C group were significantly higher than those in A group (43.33％,36.67％,20.00％) and B group (40.00％,33.33％,16.67％) (x2 =5.467,3.661,3.287,all P ＜0.05).Conclusion For patients with stage Ⅳ DTC,the combination of 131I + TSH inhibitory regimen and operation regimen can significantly improve the therapeutic effect,improve the quality of life and prolong the survival time.