Estorch M, Mitjavila M, Muros M A, Caballero E
Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2019 May-Jun;38(3):195-203. doi: 10.1016/j.remn.2018.12.008. Epub 2019 Feb 8.
In differentiated thyroid cancer (DTC), radioiodine is administered to eliminate residual normal thyroid tissue after thyroidectomy (ablative treatment), to treat residual microscopic disease (adjuvant treatment), and to treat macroscopic or metastatic disease. Currently, treatment of DTC with I is still a matter of controversy due to the absence of prospective clinical trials assessing its benefit in terms of overall survival and recurrence-free interval. The current recommendations of the experts are based on observational retrospective data and on their interpretation of the literature. Pending the results of the prospective trials that are currently underway, the use of I seems to be justified not only in high-risk patients, but also in intermediate-risk and low-risk patients. The guidelines of The American and British Thyroid Association, European and American Societies of Nuclear Medicine, The European Consensus Group and the latest edition of National Comprehensive Cancer Network (NCCN) were considered in drawing up this continuing education document, we also undertook a review of the related scientific literature.
在分化型甲状腺癌（DTC）中，甲状腺切除术后给予放射性碘以消除残留的正常甲状腺组织（消融治疗），治疗残留的微小疾病（辅助治疗），以及治疗肉眼可见的或转移性疾病。目前，由于缺乏评估其在总生存期和无复发生存期方面益处的前瞻性临床试验，用碘治疗DTC仍存在争议。专家们目前的建议基于观察性回顾性数据及其对文献的解读。在目前正在进行的前瞻性试验结果出来之前，碘的使用似乎不仅在高危患者中合理，在中危和低危患者中也合理。在编写本继续教育文件时参考了美国和英国甲状腺协会、欧美核医学协会、欧洲共识小组以及美国国立综合癌症网络（NCCN）最新版的指南，我们还对相关科学文献进行了综述。
