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[分化型甲状腺癌放射性碘治疗程序指南。第4版]

[Procedure guidelines for radioiodine therapy of differentiated thyroid cancer. Version 4].

作者信息

Dietlein Markus, Eschner Wolfgang, Grünwald Frank, Lassmann Michael, Verburg Frederik A, Luster Markus

机构信息

Prof. Dr. med. Markus Dietlein, Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Köln, Kerpener Str. 62, 50937 Köln, Tel. 02 21/478 50 24, Fax 02 21/47 88 90 85,

出版信息

Nuklearmedizin. 2016 Jun 28;55(3):77-89.

Abstract

The procedure guideline for radioiodine therapy of differentiated thyroid cancer (version 4) was developed in the consensus of a representative expert group. This fulfils the level S1 (first step) within the AWMF classification of Clinical Practice Guidelines (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Germany). This procedure guideline completed the guideline for surgical management of thyroid cancer (level S2) with the aspects from nuclear medicine. Controversies over ablative radioiodine therapy in small papillary thyroid cancers and in minimally invasive follicular cancer without angioinvasion, over empirical standard doses for ablative radioiodine therapy, and over the kind of TSH-stimulation were described and the guideline formulated a corridor of good clinical practice. The text has included the recent results from the National Cancer database and the SEER database (both from the USA), indicating that the ablative radioiodine therapy has improved the survival rate even in low risk patients. Such a statistically significant benefit can be detected only by a national cancer registry with long-term follow-up data.

摘要

分化型甲状腺癌放射性碘治疗程序指南(第4版)由一个具有代表性的专家组达成共识制定。这符合德国医学专业科学协会工作委员会(AWMF)临床实践指南分类中的S1级(第一步)。本程序指南从核医学方面完善了甲状腺癌手术管理指南(S2级)。描述了小乳头状甲状腺癌和无血管侵犯的微小浸润性滤泡癌中消融性放射性碘治疗、消融性放射性碘治疗的经验性标准剂量以及促甲状腺激素刺激类型方面的争议,并制定了良好临床实践的指导原则。文本纳入了美国国家癌症数据库和监测、流行病学和最终结果(SEER)数据库的最新结果,表明消融性放射性碘治疗即使在低风险患者中也提高了生存率。只有通过具有长期随访数据的国家癌症登记处才能检测到这种具有统计学意义的益处。

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