異形甲状腺癌患者の副甲状腺機能に対する術後のRAI治療の影響

EFFECT OF POST-SURGICAL RAI THERAPY ON PARATHYROID FUNCTION IN PATIENTS WITH DIFFERENTIATED THYROID CANCER.

• Aimi Zhang
• Panli Li
• Qiufang Liu
• Shiyao Peng
• Gang Huang
• Shaoli Song

抄録

手術後の分化型甲状腺癌（DTC）に対しては、放射性ヨード（RAI）による放射線治療が一般的な治療法となっている。本研究の目的は、手術後の RAI 治療が DTC 患者の副甲状腺機能に及ぼす影響を調べることであった。 本研究には、手術後にRAI療法を受けたDTC患者81人が登録された。残存甲状腺の大きさは、RAI療法前にテクネチウム-99m（Tc）ペルテネチウム甲状腺スキャン（Tc甲状腺スキャン）で検出した。残存甲状腺のヨード取り込み能力は、ヨード131（I）全身スキャン（WBS）で評価した。全患者を3.7GBq（100mCi）I活性で治療し、副甲状腺ホルモン（PTH）、血清カルシウム、リン、マグネシウムを治療前1日、治療後1ヶ月と3ヶ月で評価した。 その結果、3時点（治療前、治療後1ヶ月、治療後3ヶ月）で血中PTH値に統計学的に有意な差は認められなかった（＞.05）。血清カルシウム、リンは有意な変化は認められなかったが（＞.05）、血清マグネシウムは治療後に上昇した（＜.05）。PTHの変化と性別、年齢、Tc甲状腺スキャンのスコア、I WBSのスコア、腫瘍(T)病期、結節(N)病期との間には有意差はなかった。 手術後のRAI療法は、DTC患者の副甲状腺機能に有意な影響を与えなかった。=米国甲状腺協会；=分化型甲状腺癌；=遊離トリヨードサイロニン；=遊離チロキシン；=ヨウ素131；=副甲状腺ホルモン；=放射性ヨウ素；=テクネチウム99m；=サイログロブリン；=腫瘍結節転移；=甲状腺刺激ホルモン；=全身スキャン。

Radiotherapy with radioactive iodine (RAI) has become a common treatment for postsurgical differentiated thyroid carcinoma (DTC). The objective of this study was to determine the effect of RAI therapy following surgery on the function of the parathyroid glands in DTC patients. A total of 81 DTC patients who received RAI therapy after surgery were enrolled in the study. The size of the residual thyroid was detected by technetium-99m (Tc)-pertechnetate thyroid scan (Tc thyroid scan) before RAI therapy. The iodine uptake ability of residual thyroid was evaluated by iodine-131 (I) whole-body scan (WBS). All patients were treated with an activity of 3.7 GBq (100 mCi) I. Parathyroid hormone (PTH), serum calcium, phosphorus, and magnesium were evaluated at 1 day before treatment, and at 1 month and 3 months after treatment. The results show that there was no statistically significant difference in blood PTH level observed (>.05) between 3 time points (pre-treatment, 1 month post-treatment and 3 months post-treatment). The serum calcium and phosphorus did not change significantly (>.05), but serum magnesium level was elevated after treatment (<.05). There were no significant differences between PTH changes and sex, age, scores of Tc thyroid scan, scores of I WBS, Tumor (T) stage, and Node (N) stage. RAI therapy following surgery did not significantly affect parathyroid function in DTC patients. = American Thyroid Association; = differentiated thyroid carcinoma; = free triiodothyronine; = free thyroxine; = iodine-131; = parathyroid hormone; = radioiodine; = Technetium-99m; = thyroglobulin; = Tumor Node Metastasis; = thyroid-stimulating hormone; = whole-body scan.