Cabanillas Maria E, Dadu Ramona, Hu Mimi I, Lu Charles, Gunn Gary Brandon, Grubbs Elizabeth G, Lai Stephen Y, Williams Michelle D
Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1461, Houston, TX 77030, USA.
Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1461, Houston, TX 77030, USA.
Hematol Oncol Clin North Am. 2015 Dec;29(6):1123-43. doi: 10.1016/j.hoc.2015.07.011.
Surgery remains the most important effective treatment for differentiated (DTC) and medullary thyroid cancer (MTC). Radioactive iodine (RAI) is another important treatment but is reserved only for DTC whose disease captures RAI. Once patients fail primary therapy, observation is often recommended, as most DTC and MTC patients will have indolent disease. However, in a fraction of patients, systemic therapy must be considered. In recent decades 4 systemic therapies have been approved by the United States FDA for DTC and MTC. Sorafenib and lenvatinib are approved for DTC and vandetanib and cabozantinib for MTC. Anaplastic thyroid cancer (ATC) is a rare and rapidly progressive form of thyroid cancer with a very high mortality rate. Treatment of ATC remains a challenge. Most patients are not surgical candidates at diagnosis due to advanced disease. External beam radiation and radiosensitizing radiation are the mainstay of therapy at this time. However, exciting new drugs and approaches to therapy are on the horizon but it will take a concerted, worldwide effort to complete clinical trials in order to find effective therapies that will improve the overall survival for this devastating disease.
手术仍然是分化型甲状腺癌（DTC）和髓样甲状腺癌（MTC）最重要的有效治疗方法。放射性碘（RAI）是另一种重要的治疗方法，但仅适用于能摄取RAI的DTC。一旦患者初始治疗失败，通常建议进行观察，因为大多数DTC和MTC患者病情进展缓慢。然而，部分患者必须考虑全身治疗。近几十年来，美国食品药品监督管理局（FDA）已批准4种全身治疗方法用于DTC和MTC。索拉非尼和乐伐替尼被批准用于DTC，凡德他尼和卡博替尼被批准用于MTC。间变性甲状腺癌（ATC）是一种罕见且进展迅速的甲状腺癌形式，死亡率非常高。ATC的治疗仍然是一项挑战。大多数患者在诊断时由于疾病进展而不适合手术。此时，外照射放疗和放射增敏放疗是主要的治疗方法。然而，令人兴奋的新药物和治疗方法即将出现，但需要全球共同努力完成临床试验，以找到能改善这种毁灭性疾病总体生存率的有效治疗方法。
