局部晚期分化型甲状腺癌的辅助放疗和放射性碘治疗：系统评价和荟萃分析。
Adjuvant radiotherapy and radioiodine treatment for locally advanced differentiated thyroid cancer: systematic review and meta-analysis.
机构信息
Department of Radiation Oncology, European Institute of Oncology IRCCS, Milan, Italy.
Department of Radiation Oncology, ASST Spedali Civili, Brescia, Italy.
出版信息
Tumori. 2021 Dec;107(6):489-497. doi: 10.1177/0300891621996817. Epub 2021 Mar 16.
BACKGROUND
Treatment for locally advanced differentiated thyroid cancer is surgery followed by radioiodine while the role of adjuvant external beam radiotherapy (EBRT) is debated.
METHODS
The panel of the Italian Association of Radiotherapy and Clinical Oncology developed a clinical recommendation on the addition of EBRT to radioiodine after surgery for locally advanced differentiated thyroid cancer by using the Grades of Recommendation, Assessment, Development, and Evaluation methodology and the Evidence to Decision framework. A systematic review with meta-analysis about this topic was conducted with a focus on outcome of benefits and toxicity.
RESULTS
Locoregional control was improved by EBRT while no considerable toxicity impact was reported.
CONCLUSION
The panel judged uncertain the benefit/harms balance; final recommendation was conditional both for EBRT + radioiodine and radioiodine alone in the adjuvant setting.
背景
局部晚期分化型甲状腺癌的治疗方法是手术加放射性碘治疗，而辅助外照射放疗（EBRT）的作用仍存在争议。
方法
意大利放射治疗和临床肿瘤学协会小组采用推荐分级评估、制定与评价（GRADE）方法和证据决策框架，就局部晚期分化型甲状腺癌手术后加用 EBRT 的问题制定了临床推荐意见。通过系统评价和荟萃分析对这一主题进行了研究，重点关注获益和毒性的结局。
结果
EBRT 可改善局部区域控制，但未报告明显的毒性影响。
结论
专家组判断获益/危害平衡不确定；在辅助治疗中，EBRT+放射性碘和单独放射性碘的最终推荐均为有条件推荐。
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