RESUMO
Objective:To investigate the efficacy and safety of 125I seed implantation in the treatment of radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC). Methods:Fourteen patients (8 males, 6 females, age: (62.0±10.7) years) with RAIR-DTC confirmed by pathology or imaging examination in the Central Hospital of Wuhan, Tongji Medical College between July 2017 and March 2021, were retrospectively analyzed. The patients were treated with 125I seed implantation guided by CT. Ultrasound, CT, 125I-SPECT/CT or MRI were performed at 1.5, 3, 6 and 12 months after the implantation to evaluate the changes of lesion volume, and serum thyroglobulin (Tg), as well as symptom relief were monitored and recorded. The paired t-test was used for data analysis. Results:The 125I seeds were successfully implanted (16 operations) in 14 patients with 25 lesions. Patients were followed up for 3-44 months (median: 6.5(4.5, 11.5) months). The total effective rate was 60.0%(15/25) and the total local control rate was 96.0%(24/25). The effective rate for metastatic lymph nodes was 10/17, and the local control rate was 16/17. The effective rate and the local control rate for local recurrence were 1/3 and 3/3 respectively, and those for bone metastasis were both 3/3, those for sinus metastasis were 0/1 and 1/1 respectively, and those for lung metastasis were both 1/1. In 8 patients with clinical symptoms, symtoms of 4 cases were completely relieved, those of 3 cases were partially relieved and 1 case had no remission. The Tg level and the tumor length were both decreased after operation ((245.99±44.85) μg/L vs (330.38±50.78) μg/L, t=2.92, P=0.010; (2.71±0.34) cm vs (3.78±0.27) cm, t=3.13, P=0.007). Conclusions:125I seed implantation, as a supplementary treatment for RAIR-DTC, is safe and effective. It has a good effect against metastatic and local recurrent lesions.
