Effect and influencing factors on 131I treatment for cervical lymph node metastasis from papillary thyroid cancer / 中华核医学与分子影像杂志

ABSTRACT

Objective To assess the effect and influencing factors on 131I treatment for cervical lymph node metastasis (LNM) after operation in patients with PTC.Methods PTC patients (n =117;45 males,72 females;average age (45.17± 15.50) years) with postoperative cervical LNM from January 2010 to December 2014 were analyzed retrospectively.LNM was diagnosed by surgical pathology,imaging results and clinical follow-up.Single factor analysis was performed in age,gender,operation mode,TNM stage,131I treatment time and other factors.The results for 131I treatment effect included CR,PR,NC.Two-sample t test and x2 test were used.Results Among the 117 PTC patients with postoperative LNM,53 (45.3％) cases had non-131 I-avid metastasis.Fifty of the 64 (54.7％) patients with 131I-avid metastasis were treated with 131I.Nineteen patients (38.0％) achieved CR,22 (44.0％) achieved PR,and 9 (18.0％) showed invalid results.Fourteen of the 64 patients underwent another cervical lymph node dissection.Nine patients achieved CR,5 patients achieved PR,and 4 PR patients were then treated with 131I and finally achieved CR.Single factor analysis showed that the influencing factors of non-131I-avid lymph node included patients' age (t =3.459),serum Tg level (x2 =6.698) and metastasis with 1s F-FDG uptake (x2 =26.928;all P＜0.05).The influencing factors of 131I treatment effect included lymph node dissection procedure (x2 =6.487),unilateral or bilateral lesion (x2=5.187) and LNM size (x2=8.099;all P＜0.05).Conclusions 131I treatment is ineffective for nearly 50％ of patients with non-131I-avid LNM.The influencing factors of 131I treatment effect include the lymph node dissection procedure,unilateral or bilateral lesions and LNM size.