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甲状腺乳头状癌(papillary thyroid carcinoma,PTC)是一种低度恶性的甲状腺癌,约占甲状腺肿瘤的85%,首发症状常表现为颈部无痛性肿块,进展至晚期阶段可侵犯压迫邻近组织、器官,引起声音嘶哑、呼吸困难、吞咽不畅等症状。目前国内外针对晚期PTC的治疗意见并不一致,特别是外照射治疗(external-beam radiotherapy,EBRT),在晚期PTC治疗中的作用及地位尚未形成共识。本文就EBRT在晚期PTC治疗中的作用及研究进展做一综述。
放射治疗在晚期甲状腺乳头状癌中的研究进展
Role of radiation therapy in the treatment of advanced papillary thyroid carcinoma and its research progress
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摘要: 甲状腺乳头状癌(PTC)是内分泌系统及头颈部肿瘤中最为常见的恶性肿瘤之一,晚期PTC的治疗手段以外科切除为主,术后给予131I辅助治疗。甲状腺癌术后,约30%的患者发生肿瘤失分化而丧失特异性摄碘功能, 因此这部分患者失去术后131I治疗的机会。近年来,随着甲状腺癌发病率的快速增长,此类患者数量急剧增加。对于手术不能彻底清除病灶或丧失131I治疗机会的患者,外照射治疗(EBRT)已成为主要的辅助治疗手段。虽然EBRT在以往PTC晚期治疗中作用较为局限,但随着技术的发展与提高,其不良反应减小,EBRT在晚期PTC治疗中逐渐发挥其最大优势。Abstract: Papillary thyroid carcinoma(PTC) is one of the most common malignant tumors in the endocrine and head-neck system. Surgical resection is the mainly treatment used in advanced PTC patients, and 131I is used as adjuvant treatment. However, nearly 30% of patients suffering from tumor dedifferentiation fail to uptake iodine after thyroid cancer surgery; thus, these patients lose the opportunity to undergo postoperative 131I treatment. Recently, with the rapid increase in the incidence of thyroid cancer, the number of such patients has increased dramatically, and radiation therapy gradually plays an important role in the adjuvant therapy. Although radiotherapy has been limited for advanced PTC patients in the past, with the development of radiotherapy technology, external-beam radiotherapy(EBRT) has slowly displayed its greatest superiority for these patients.
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Key words:
- Thyroid neoplasms /
- Radiotherapy /
- Iodine radioisotopes
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