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分化型甲状腺癌患者术后放射性碘治疗

Postoperative radioactive iodine administration for differentiated thyroid cancer patients.

作者信息

Lepoutre-Lussey Charlotte, Deandreis Désirée, Leboulleux Sophie, Schlumberger Martin

机构信息

Gustave Roussy, University Paris Sud, Villejuif, Paris, France.

出版信息

Curr Opin Endocrinol Diabetes Obes. 2014 Oct;21(5):363-71. doi: 10.1097/MED.0000000000000100.

DOI:10.1097/MED.0000000000000100
PMID:25119656
Abstract

PURPOSE OF REVIEW

Radioactive iodine (RAI) is administered postoperatively to the majority of thyroid cancer patients. No available study has demonstrated any benefit in low-risk patients.

RECENT FINDINGS

RAI should be used selectively in low and intermediate-risk patients, based on the surgical and pathological reports and on postoperative serum thyroglobulin level and neck ultrasonography. When used, a low activity (30 mCi) is administered following recombinant human thyrotropin stimulation. High-risk patients are treated with a high activity of RAI (100 mCi or more).

SUMMARY

RAI is not administered in many low-risk patients who can be reliably followed up with serum thyroglobulin determination on L-thyroxine treatment and neck ultrasonography. RAI may be administered in case of abnormality, and this delay will not reduce the chance of cure.

摘要

综述目的

大多数甲状腺癌患者术后会接受放射性碘(RAI)治疗。目前尚无研究表明其对低风险患者有任何益处。

最新发现

应根据手术和病理报告、术后血清甲状腺球蛋白水平及颈部超声检查,对低风险和中风险患者选择性使用RAI。使用时,在重组人促甲状腺素刺激后给予低活度(30 mCi)的RAI。高风险患者接受高活度(100 mCi或更高)的RAI治疗。

总结

许多低风险患者在接受左甲状腺素治疗时通过血清甲状腺球蛋白测定及颈部超声检查能够得到可靠的随访,无需接受RAI治疗。如有异常情况可给予RAI治疗,这种延迟不会降低治愈几率。

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Postoperative radioactive iodine administration for differentiated thyroid cancer patients.分化型甲状腺癌患者术后放射性碘治疗
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Evaluation of surgical completeness in endoscopic thyroidectomy compared with open thyroidectomy with regard to remnant ablation.内镜甲状腺切除术与开放性甲状腺切除术在残余消融方面的手术完整性评估。
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Radioactive iodine therapy.放射性碘治疗。
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Effect of prophylactic central compartment neck dissection on serum thyroglobulin and recommendations for adjuvant radioactive iodine in patients with differentiated thyroid cancer.预防性中央区颈部清扫术对分化型甲状腺癌患者血清甲状腺球蛋白的影响及辅助放射性碘治疗的建议。
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Radioiodine remnant ablation in low-risk differentiated thyroid cancer.低危分化型甲状腺癌的放射性碘残留消融
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Postoperative management of differentiated thyroid cancer.分化型甲状腺癌的术后管理
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Rapid rise in serum thyrotropin concentrations after thyroidectomy or withdrawal of suppressive thyroxine therapy in preparation for radioactive iodine administration to patients with differentiated thyroid cancer.分化型甲状腺癌患者在甲状腺切除术后或为进行放射性碘治疗而停用抑制性甲状腺素治疗后,血清促甲状腺素浓度迅速升高。
J Clin Endocrinol Metab. 2004 Jul;89(7):3285-9. doi: 10.1210/jc.2003-031139.
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Follow-up of differentiated thyroid carcinoma.分化型甲状腺癌的随访
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Changing concepts in the management of differentiated thyroid cancer.分化型甲状腺癌管理理念的转变
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Application of post-surgical stimulated thyroglobulin for radioiodine remnant ablation selection in low-risk papillary thyroid carcinoma.应用术后刺激甲状腺球蛋白筛选低危型甲状腺乳头状癌患者行放射性碘清甲治疗。
Head Neck. 2010 Jun;32(6):689-98. doi: 10.1002/hed.21371.

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2
Thyroglobulin-Based Risk Factor Repositioning for Determining Radioactive Iodine Activity in Patients with Papillary Thyroid Carcinoma: a Multicenter Retrospective Cohort Study.基于甲状腺球蛋白的风险因素重新定位以确定甲状腺乳头状癌患者的放射性碘活性:一项多中心回顾性队列研究
Nucl Med Mol Imaging. 2022 Aug;56(4):173-180. doi: 10.1007/s13139-022-00756-4. Epub 2022 Jun 18.
3
Risk of recurrence in patients with papillary thyroid carcinoma and minimal extrathyroidal extension not treated with radioiodine.
未接受放射性碘治疗的伴有微小甲状腺外侵犯的甲状腺乳头状癌患者的复发风险。
J Endocrinol Invest. 2019 Jun;42(6):687-692. doi: 10.1007/s40618-018-0969-y. Epub 2018 Oct 23.
4
Recombinant human TSH versus thyroid hormone withdrawal in adjuvant therapy with radioactive iodine of patients with papillary thyroid carcinoma and clinically apparent lymph node metastases not limited to the central compartment (cN1b).重组人促甲状腺素与甲状腺激素撤减在放射性碘辅助治疗甲状腺乳头状癌且临床明显淋巴结转移不限于中央区(cN1b)患者中的比较
Arch Endocrinol Metab. 2017 Mar-Apr;61(2):167-172. doi: 10.1590/2359-3997000000247. Epub 2017 Feb 13.