甲状腺癌的放射治疗
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摘要
随着甲状腺癌诊疗水平的提高,甲状腺癌的治疗手段也不断提升和进步。目前,甲状腺癌的治疗以手术、促甲状腺激素(TSH)抑制治疗和放射性碘治疗为主,而随着计算机、影像与放疗设备的发展,放射治疗逐渐成为甲状腺癌一种重要的辅助治疗手段。对于一部分手术不能彻底清除的病灶或丧失~(131)I治疗机会的晚期甲状腺癌,外放射治疗也逐渐起到重要作用。但目前外放射治疗在临床开展的不够广泛,临床疗效不甚明确,在甲状腺癌治疗中的作用还存在一定争议。
With the obvious improvement of the diagnosis and treatment level of thyroid cancer,the treatment methods of thyroid cancer have also been improved.The treatment of thyroid cancer is dominated by surgery,TSH inhibition therapy and radioactive iodine therapy. With the development of computer, imaging and radiotherapy equipment,radiotherapy has gradually become an important auxiliary treatment for thyroid cancer. For parts of the cases which operation could not thoroughly remove lesions or lost 131I treatment of thyroid cancer,external beam radiotherapy is increasingly being used for adjuvant therapy.Although external beam radiotherapy has gradually played a significant role,currently EBRT is not widely used in the clinic,and the therapeutic effect has been controversial yet in the treatment of thyroid cancer.
With the obvious improvement of the diagnosis and treatment level of thyroid cancer,the treatment methods of thyroid cancer have also been improved.The treatment of thyroid cancer is dominated by surgery,TSH inhibition therapy and radioactive iodine therapy. With the development of computer, imaging and radiotherapy equipment,radiotherapy has gradually become an important auxiliary treatment for thyroid cancer. For parts of the cases which operation could not thoroughly remove lesions or lost 131I treatment of thyroid cancer,external beam radiotherapy is increasingly being used for adjuvant therapy.Although external beam radiotherapy has gradually played a significant role,currently EBRT is not widely used in the clinic,and the therapeutic effect has been controversial yet in the treatment of thyroid cancer.
引文
[1]殷德涛,李红强.甲状腺手术方式的发展现状及展望[J].国际外科学杂志,2017,44(12):797-799.
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[14]田琼香.晚期分化型甲状腺癌的规范治疗[J].航空航天医学杂志,2014,25(4):474-475.
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[16]Martinez SR,Beal SH,Chen A,et al.Adjuvant external beam radiation for medullary thyroid carcinoma[J].J Surg Oncol,2010,102(2):175-178.
[17]He X,Li D,Hu C,et al.Outcome after intensity modulated radiotherapy for anaplastic thyroid carcinoma[J].BMC Cancer,2014,14:235.
[18]姜仁伟,王思阳,郭栓栓,等.不同放射剂量对甲状腺癌术后残余癌放疗的效果观察[J].临床医学研究与实践,2017,2(24):17-18.
[19]董志伟,郝志.不同放射剂量对甲状腺癌术后残余癌放疗效果及患者生存率的影响[J].中国地方病防治杂志,2016,31(2):223-224.
[20]梁艳芳,温清泉,梁颖莹,等.不同放射剂量放疗对甲状腺癌术后残余癌患者生存期和淋巴细胞亚群的影响[J].中国普通外科杂志,2017,26(11):1485-1488.
[21]Guimar es RM,Muzi CD,Parreira VG,et al.Evolution of thyroid cancer mortality in adults in Brazil[J].Arquivos Brasileiros De Endocrinologia E Metabologia,2013,57(7):538-544.
[22]Kwon J,Wu HG,Youn YK,et al.Role of adjuvant postoperative external beam radiotherapy for well differentiated thyroid cancer[J].Radiat Oncol J,2013,31(3):162-170.
[23]Tuttle RM,Rondeau G,Lee NY.A risk-adapted approach to the use of radioactive iodine and external beam radiation in the treatment of well-differentiated thyroid cancer[J].Cancer Control,2011,18(2):89-95.
[24]Nachalon Y,Stern-Shavit S,Bachar G,et al.Aggressive palliation and survival in anaplastic thyroid carcinoma[J].JAMAOtolaryngol Head Neck Surg,2015,141(12):1128-1132.
[25]Ito K,Hanamura T,Murayama K,et al.Multimodality therapeutic outcomes in anaplastic thyroid carcinoma:improved survival in subgroups of patients with localized primary tumors[J].Head Neck,2012,34(2):230-237.
[26]Chang JW,Kang SU,Choi JW,et al.Tolfenamic acid induces apoptosis and growth inhibition in anaplastic thyroid cancer:Involvement of nonsteroidal anti-inflammatory drug-activated gene-1 expression and intracellular reactive oxygen species generation[J].Free Radic Biol Med,2014,67:115-130.
[27]Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.a
[2]Park JW,Choi SH,Hong IY,et al.Treatment outcomes of radiotherapy for anaplastic thyroid cancer[J].Radiat Oncol J,2018,36(2):103-113.
[3]Hamilton SN,Tran E,Berthelet E,et al.The role of external beam radiation therapy in well-differentiated thyroid cancer[J].Expert Rev Anticancer Ther,2017,17(10):905-910.
[4]中华医学会核医学分会.131I治疗分化型甲状腺癌指南(2014版)[J].中华核医学与分子影像杂志,2014,34(4):264-278.
[5]高军茂.甲状腺癌的放射治疗[J].中国医学文摘(耳鼻咽喉科学),2012,27(3):143-146.
[6]张九成,任庆荣,廖玲霞,等.调强放疗甲状腺癌术后残留的疗效分析[J].实用癌症杂志,2014,29(6):648-650.
[7]Romesser PB,Sherman EJ,Shaha AR,et al.External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer[J].JSurg Oncol,2014,110(4):375-382.
[8]Glaser SM,Mandish SF,Gill BS,et al.Anaplastic thyroid cancer:Prognostic factors,patterns of care,and overall survival[J].Head Neck,2016,38(suppl 1):E2083-2090.
[9]Megwalu UC,Orloff LA,Ma Y.Adjuvant external beam radiotherapy for locally invasive papillary thyroid cancer[J].Neck,2019 Jan 8.doi:10.1002/hed.25639.[Epub ahead of print].
[10]Nixon IJ,Whitcher MM,Palmer FL,et al.The impact of distant metastases at presentation on prognosis in patients with differentiated carcinoma of the thyroid gland[J].Thyroid,2012,22(9):884-889.
[11]Ito Y,Miyauchi A,Ito M,et al.Prognosis and prognostic factors of differentiated thyroid carcinoma after the appearance of metastasis refractory to radioactive iodine therapy[J].Endocr J,2014,61(8):821-824.
[12]Kim SJ,Myong JP,Suh H,et al.Optimal cutoff age for predicting mortality associated with differentiated thyroid cancer[J].PLoS One,2015,10(6):e0130848.
[13]孙威,贺亮,张浩.美国癌症联合委员会甲状腺癌分期系统(第8版)更新解读[J].中国实用外科杂志,2017,37(3):255-258.
[14]田琼香.晚期分化型甲状腺癌的规范治疗[J].航空航天医学杂志,2014,25(4):474-475.
[15]So K,Smith RE,Davis SR.Radiotherapy in well-differentiated thyroid cancer:is it underutilized?[J].ANZ J Surg,2016,86(9):696-700.
[16]Martinez SR,Beal SH,Chen A,et al.Adjuvant external beam radiation for medullary thyroid carcinoma[J].J Surg Oncol,2010,102(2):175-178.
[17]He X,Li D,Hu C,et al.Outcome after intensity modulated radiotherapy for anaplastic thyroid carcinoma[J].BMC Cancer,2014,14:235.
[18]姜仁伟,王思阳,郭栓栓,等.不同放射剂量对甲状腺癌术后残余癌放疗的效果观察[J].临床医学研究与实践,2017,2(24):17-18.
[19]董志伟,郝志.不同放射剂量对甲状腺癌术后残余癌放疗效果及患者生存率的影响[J].中国地方病防治杂志,2016,31(2):223-224.
[20]梁艳芳,温清泉,梁颖莹,等.不同放射剂量放疗对甲状腺癌术后残余癌患者生存期和淋巴细胞亚群的影响[J].中国普通外科杂志,2017,26(11):1485-1488.
[21]Guimar es RM,Muzi CD,Parreira VG,et al.Evolution of thyroid cancer mortality in adults in Brazil[J].Arquivos Brasileiros De Endocrinologia E Metabologia,2013,57(7):538-544.
[22]Kwon J,Wu HG,Youn YK,et al.Role of adjuvant postoperative external beam radiotherapy for well differentiated thyroid cancer[J].Radiat Oncol J,2013,31(3):162-170.
[23]Tuttle RM,Rondeau G,Lee NY.A risk-adapted approach to the use of radioactive iodine and external beam radiation in the treatment of well-differentiated thyroid cancer[J].Cancer Control,2011,18(2):89-95.
[24]Nachalon Y,Stern-Shavit S,Bachar G,et al.Aggressive palliation and survival in anaplastic thyroid carcinoma[J].JAMAOtolaryngol Head Neck Surg,2015,141(12):1128-1132.
[25]Ito K,Hanamura T,Murayama K,et al.Multimodality therapeutic outcomes in anaplastic thyroid carcinoma:improved survival in subgroups of patients with localized primary tumors[J].Head Neck,2012,34(2):230-237.
[26]Chang JW,Kang SU,Choi JW,et al.Tolfenamic acid induces apoptosis and growth inhibition in anaplastic thyroid cancer:Involvement of nonsteroidal anti-inflammatory drug-activated gene-1 expression and intracellular reactive oxygen species generation[J].Free Radic Biol Med,2014,67:115-130.
[27]Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.a