Alobuia Wilson, Gillis Andrea, Kebebew Electron
Division of General Surgery, Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3591, Stanford, CA, 94305, USA.
Division of General Surgery, Department of Surgery, Albany Medical College, 43 New Scotland Avenue, MC - 61, Albany, NY, 12208, USA.
Curr Treat Options Oncol. 2020 Aug 7;21(10):78. doi: 10.1007/s11864-020-00776-2.
Anaplastic thyroid cancer (ATC) is a rare but very aggressive form of undifferentiated thyroid cancer. Due to its rapid rate of progression and invasive nature, ATC poses significant risks of morbidity and mortality. The cornerstone in the management of ATC remains a prompt diagnosis of the disease and timely management of complications depending on the stage of disease. Surgery continues to offer a higher chance of a cure, although not all patients are candidates for surgical management. Patients with advanced disease may be considered for palliative surgery to reduce morbidity and complications from advanced disease. With the advent of new molecular testing and improved methods of diagnosis, novel therapeutic targets have been identified. Systemic therapy (chemotherapy and radiation therapy) as well as novel immunotherapy have shown some promise in patients with targetable genetic mutations. Patients should therefore have molecular testing of their tumor-if it is unresectable-and be tested for mutations that are targetable. Mutation-targeted therapy may be effective and may result in a significant response to allow surgical intervention for exceptional responders. Overall, patients who receive all three modalities of therapy (surgery, chemotherapy, and radiation therapy) have the highest overall survival.
间变性甲状腺癌（ATC）是一种罕见但极具侵袭性的未分化甲状腺癌。由于其进展迅速且具有侵袭性，ATC会带来显著的发病和死亡风险。ATC治疗的基石仍然是对该疾病的及时诊断以及根据疾病阶段对并发症进行及时处理。手术仍然提供了更高的治愈机会，尽管并非所有患者都适合手术治疗。晚期疾病患者可考虑进行姑息性手术，以降低晚期疾病的发病率和并发症。随着新的分子检测技术的出现和诊断方法的改进，已确定了新的治疗靶点。全身治疗（化疗和放疗）以及新型免疫疗法在具有可靶向基因突变的患者中已显示出一些前景。因此，如果肿瘤无法切除，患者应进行肿瘤的分子检测，并检测是否存在可靶向的突变。针对突变的治疗可能有效，并可能导致显著反应，从而使特殊反应者能够接受手术干预。总体而言，接受所有三种治疗方式（手术、化疗和放疗）的患者总体生存率最高。
