Patients with differentiated thyroid cancer have a good prognosis after surgical treatment, but there are still some patients with recurrence or metastasis.Local/regional recurrent lesions invade or compress the surrounding organs such as esophagus and trachea,and appear fistula,obstruction,bleeding and other manifestations. For such patients,local treatment should be preferred to effectively control tumor growth and alleviate symptoms. Local treatment is an important means to control local lesions and has an important position in the treatment of malignant tumors. It can be used for local treatment of recurrent thyroid cancer,including reoperation,ablation, 125I seed implantation,external beam radiotherapy. This review reviews the local treatment effects and complications of local/regional recurrence of differentiated thyroid cancer according to the guidelines and related literature.

Objective:To investigate the efficacy and influencing factors of iodine-125 seed implantation in the treatment of recurrent radioiodine refractory differentiated thyroid carcinoma (RAIR-DTC) .Methods:Retrospective analysis of 18 patients with recurrent RAIR-DTC treated with iodine-125 particle implantation at Ward One, Department of Oncology, Hebei General Hospital from Sept. 2015 to Mar. 2022 was performed. A total of 35 lesions were involved, all permanently implanted with iodine-125 particles under image guidance, with particle activity ranging from 0.3mCi to 0.8mCi, and prescription doses ranging from 80 to 140 Gy. The study observed the objective response rate, local control rate, survival rate, adverse reactions, and factors influencing treatment efficacy.Results:After a follow-up period of 8 to 115 months,according to the objective efficacy evaluation criteria of solid tumors 1.1,the objective response rates were 51.4% (18/35) ,80.0% (28/35) ,68.6% (24/35) ,60.0% (21/35) ,42.9% (15/35) at 3,6,12,24,36 months postoperatively,respectively.The local control rates were 100% (35/35) ,100% (35/35) ,80.0% (28/35) ,62.9% (22/35) ,51.4% (18/35) at 3,6,12,24,36 months postoperatively,respectively.The 1-,2-, and 3-year postoperative survival rates were 83.3% (15/18) ,72.2% (13/18) ,61.1% (11/18) ,respectively.During the follow-up period,4 patients developed progressive lesions in the target area.One grade I radioactive skin injury,one grade Ⅱ radioactive skin injury,and no residual particle-related adverse reactions.The results of multivariate analysis showed that D90,tumor involvement of the esophagus were the factors influencing the recent efficacy.The area under the ROC curve for D90 was 0.804 with the best bound of 106.5Gy.Conclusion:Iodine-125 particle implantation is safe and effective for recurrent RAIR-DTC.D90,tumor involvement of the esophagus are the influencing factors of the recent efficacy,and the D90≥106.5Gy treatment effect is better.

Patients with differentiated thyroid cancer have a good prognosis after surgical treatment, but there are still some patients with recurrence or metastasis.Local/regional recurrent lesions invade or compress the surrounding organs such as esophagus and trachea,and appear fistula,obstruction,bleeding and other manifestations. For such patients,local treatment should be preferred to effectively control tumor growth and alleviate symptoms. Local treatment is an important means to control local lesions and has an important position in the treatment of malignant tumors. It can be used for local treatment of recurrent thyroid cancer,including reoperation,ablation, 125I seed implantation,external beam radiotherapy. This review reviews the local treatment effects and complications of local/regional recurrence of differentiated thyroid cancer according to the guidelines and related literature.

Objective:To investigate the efficacy and influencing factors of iodine-125 seed implantation in the treatment of recurrent radioiodine refractory differentiated thyroid carcinoma (RAIR-DTC) .Methods:Retrospective analysis of 18 patients with recurrent RAIR-DTC treated with iodine-125 particle implantation at Ward One, Department of Oncology, Hebei General Hospital from Sept. 2015 to Mar. 2022 was performed. A total of 35 lesions were involved, all permanently implanted with iodine-125 particles under image guidance, with particle activity ranging from 0.3mCi to 0.8mCi, and prescription doses ranging from 80 to 140 Gy. The study observed the objective response rate, local control rate, survival rate, adverse reactions, and factors influencing treatment efficacy.Results:After a follow-up period of 8 to 115 months,according to the objective efficacy evaluation criteria of solid tumors 1.1,the objective response rates were 51.4% (18/35) ,80.0% (28/35) ,68.6% (24/35) ,60.0% (21/35) ,42.9% (15/35) at 3,6,12,24,36 months postoperatively,respectively.The local control rates were 100% (35/35) ,100% (35/35) ,80.0% (28/35) ,62.9% (22/35) ,51.4% (18/35) at 3,6,12,24,36 months postoperatively,respectively.The 1-,2-, and 3-year postoperative survival rates were 83.3% (15/18) ,72.2% (13/18) ,61.1% (11/18) ,respectively.During the follow-up period,4 patients developed progressive lesions in the target area.One grade I radioactive skin injury,one grade Ⅱ radioactive skin injury,and no residual particle-related adverse reactions.The results of multivariate analysis showed that D90,tumor involvement of the esophagus were the factors influencing the recent efficacy.The area under the ROC curve for D90 was 0.804 with the best bound of 106.5Gy.Conclusion:Iodine-125 particle implantation is safe and effective for recurrent RAIR-DTC.D90,tumor involvement of the esophagus are the influencing factors of the recent efficacy,and the D90≥106.5Gy treatment effect is better.

Objective To investigate the effects of captopril on cardiac function and levels of energy-rich phosphates in pressure overload induced left ventricular hypertrophy rats. Methods One hundred and twenty SD rats were randomly divided into three groups: sham operation group (SH group, n=40),coarctation of abdominal aorta group (CAA group, n=40) and captopril treatment 1 mg· 1001·d-1) group (CAP group, n=40). Left ventricular end-diastolic pressure (LVEDP), left ventricular mass index (LVMI), levels of energy-rich phosphates and morphological changes of the myocardial mitochondria were compared at the 6th and 8th week after operation. Results At 6th week, in CAA group, LVMI and LVEDP were increased and ±dp/dtmax was decreased, while ATP and ADP were decreased and AMP was increased (P<0.01). These changes were much obvious at 8th week (P<0.01). Compared with those of CAA group, the parameters of heart function and energy-rich phosphates (ATP, ADP, AMP, TAN) in CAP group were improved significantly(P<0.01) at the 6th and 8th week. In CAP group, the parameters of heart function and energy-rich phosphates (ADP, AMP, TAN) were much better at 8th week than those at 6th week. The morphological change of mitochondria was less in CAP group than that in CAA group. Conclusion Captopril significantly improves myocardial energy metabolism in pressure overload rats and protects the function of myocardial mitochondria.