Department of Nuclear Medicine and Endocrine Oncology, Centre de Référence Tumeurs Réfractaires de la Thyroïde, Institut Gustave Roussy and University Paris-Sud, Villejuif, France.
J Endocrinol Invest. 2012;35(6 Suppl):40-4.
A small but not irrelevant percentage of differentiated thyroid cancers become refractory to radioiodine treatment either because they lose the ability of taking up iodine over the time or because, despite a persistent uptaking ability, the effect of the radioiodine is lost in terms of tumor burden reduction. These patients receive only few and transient benefits from other conventional therapies and particularly from chemotherapy. In the last decade, several new drugs have been discovered as potentially useful and tested in clinical trials. They are mainly represented by protein kinase inhibitor molecules that should be proposed to advanced and progressive 131I refractory thyroid cancer patients by enrolling them in clinical trials or by the "off label" use of the drug.
一小部分分化型甲状腺癌对放射性碘治疗产生耐药性，这一比例虽然不高，但也不容小觑。耐药的原因可能是肿瘤随着时间的推移逐渐丧失摄取碘的能力，也可能是尽管肿瘤持续摄取碘，但放射性碘在减轻肿瘤负荷方面的效果却丧失了。这些患者从其他传统疗法，特别是化疗中获益甚微。在过去的十年中，已经发现了几种新的药物，这些药物具有潜在的治疗效果，并在临床试验中得到了验证。它们主要是蛋白激酶抑制剂分子，对于进展期和转移性 131I 难治性甲状腺癌患者，应通过临床试验或“超适应证”使用这些药物，建议将这些药物用于这些患者。
