Oliván-Sasot P, Falgás-Lacueva M, García-Sánchez J, Vera-Pinto V, Olivas-Arroyo C, Bello-Arques P
Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España.
Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España.
Rev Esp Med Nucl Imagen Mol. 2017 Mar-Apr;36(2):116-119. doi: 10.1016/j.remn.2016.08.001. Epub 2016 Oct 25.
In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with Iodine (I), and TSH suppression. However, the treatment with I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with Lu-DOTATATE, showing an excellent clinical and analytical response.
对于分化型甲状腺癌患者,遵循的标准治疗方案是手术、用碘(I)消融甲状腺残余组织以及抑制促甲状腺激素(TSH)。然而,I治疗在某些情况下无效,并且由于细胞去分化导致碘摄取丧失,它不再成为一种治疗选择。尽管患者并非总是有反应,但全身治疗可作为其他选择使用;因此,疾病可能进展且治疗选择可能用尽。内分泌肿瘤可能表达生长抑素受体,这一特性不仅用于诊断,还通过用放射性同位素标记生长抑素类似物来用于治疗。一名患有碘难治性滤泡性甲状腺癌且表达生长抑素受体的患者就是如此,用Lu-DOTATATE治疗后显示出极佳的临床和分析反应。