CAJ | 학술논문

目的探讨儿童及青少年分化型甲状腺癌(DTC)的特征及评价131Ⅰ治疗的疗效及安全性.方法共38例儿童及青少年DTC患者,平均年龄16.4岁,男10例,女28例,男女比例为1:2.8;其中37例为乳头状癌,1例为滤泡状癌.所有患者均伴有淋巴结转移,其中单纯淋巴结转移21例,合并肺转移15例,同时合并脑转移和骨转移2例.23例行双侧甲状腺全切除,7例行甲状腺次全切除,5例行单叶甲状腺切除,2例行部分甲状腺切除,1例行单纯肿瘤切除.所有患者术后均接受131Ⅰ治疗,并进行随访.结果 131Ⅰ治疗后随访1～17年,无瘤生存14例,病情明显缓解16例,病情稳定8例.所有患者未出现新的转移及继发肿瘤.结论儿童及青少年DTC易转移及复发,术后行131Ⅰ治疗安全有效,可明显改善患者生存质量.
목적 탐토인동급청소년분화형갑상선암(DTC)적특정급평개131Ⅰ치료적료효급안전성.방법 공38례인동급청소년DTC환자,평균년령16.4세,남10례,녀28례,남녀비례위1:2.8;기중37례위유두상암,1례위려포상암.소유환자균반유림파결전이,기중단순림파결전이21례,합병폐전이15례,동시합병뇌전이화골전이2례.23례행쌍측갑상선전절제,7례행갑상선차전절제,5례행단협갑상선절제,2례행부분갑상선절제,1례행단순종류절제.소유환자술후균접수131Ⅰ치료,병진행수방.결과 131Ⅰ치료후수방1～17년,무류생존14례,병정명현완해16례,병정은정8례.소유환자미출현신적전이급계발종류.결론 인동급청소년DTC역전이급복발,술후행131Ⅰ치료안전유효,가명현개선환자생존질량.
Objective Children with differentiated thyroid cancer (DTC) frequently present with more extensive disease than adults. The aim of this study was to characterize the clinical features of child-hood and adolescent DTC and evaluate the outcome and safety of radioiodine treatment. Methods The re-cords of 38 childhood and adolescent DTC cases, with 28 females and 10 males (mean age: 16.4 years) were reviewed. At diagnosis, all had metastatic lesions with 38 at regional lymph nodes, 15 at lung, 2 at brain and bone. Twenty-three had a total thyroidectomy, 7 had subtotal thyroidectomy, 5 had lobectomy, and 3 had other treatment. All received post-operative radioiodine therapy. All had follow-up for at least one year. Results At the time of follow-up, all were survive (with a median follow-up of 5.13 years). Four-teen patients had no evidence of disease, 16 had partial remission, and 8 were stable disease. Conclusions DTC of the thyroid in childhood and adolescent has high risks of residual/recurrence and metastasis. Post-thyroidectomy oral administration of radioiodine was an effective and safety adjuvant therapy for outcomes.