Schlumberger Martin, Chougnet Cécile, Baudin Eric, Leboulleux Sophie
Institut Gustave-Roussy, université Paris-Sud, service de médecine nucléaire et d'oncologie endocrinienne, 94805 Villejuif cedex, France.
Presse Med. 2011 Dec;40(12 Pt 1):1189-98. doi: 10.1016/j.lpm.2011.09.011. Epub 2011 Nov 9.
Refractory thyroid cancers include medullary and differentiated cancers with locally advanced disease that is not amenable to surgery or with distant metastases, differentiated thyroid carcinomas being refractory to radio-iodine treatment and all anaplastic carcinomas. These carcinomas are rare, with an estimated incidence in France of 350 new cases per year. Their management may benefit from the TUTHYREF network. Kinase inhibitors inhibit kinases of the VEGF receptors, and this inhibits angiogenesis, and some of these agents also inhibit other kinases of the MAPkinase pathway. These inhibitors are effective in differentiated and medullary thyroid cancers, and induce a partial response or a long-term stabilisation in more than half of patients. Their toxicity is significant and these treatments should be given only to selected patients with locally advanced or metastatic disease, with progression or with clinical symptoms.
难治性甲状腺癌包括局部晚期无法手术或有远处转移的髓样癌和分化型癌、对放射性碘治疗难治的分化型甲状腺癌以及所有间变性癌。这些癌症较为罕见，据估计在法国每年有350例新发病例。它们的治疗可能受益于TUTHYREF网络。激酶抑制剂可抑制血管内皮生长因子（VEGF）受体的激酶，从而抑制血管生成，其中一些药物还可抑制丝裂原活化蛋白激酶（MAP激酶）途径的其他激酶。这些抑制剂对分化型和髓样甲状腺癌有效，可使半数以上患者产生部分缓解或长期病情稳定。其毒性较大，这些治疗仅应给予局部晚期或转移性疾病、病情进展或有临床症状的特定患者。
