Dana-Farber/Brigham and Women's Cancer Center.
Vanderbilt-Ingram Cancer Center.
J Natl Compr Canc Netw. 2022 Aug;20(8):925-951. doi: 10.6004/jnccn.2022.0040.
Differentiated thyroid carcinomas is associated with an excellent prognosis. The treatment of choice for differentiated thyroid carcinoma is surgery, followed by radioactive iodine ablation (iodine-131) in select patients and thyroxine therapy in most patients. Surgery is also the main treatment for medullary thyroid carcinoma, and kinase inhibitors may be appropriate for select patients with recurrent or persistent disease that is not resectable. Anaplastic thyroid carcinoma is almost uniformly lethal, and iodine-131 imaging and radioactive iodine cannot be used. When systemic therapy is indicated, targeted therapy options are preferred. This article describes NCCN recommendations regarding management of medullary thyroid carcinoma and anaplastic thyroid carcinoma, and surgical management of differentiated thyroid carcinoma (papillary, follicular, Hürthle cell carcinoma).
分化型甲状腺癌的预后通常较好。分化型甲状腺癌的治疗首选手术，部分患者术后可行放射性碘 131（碘-131）治疗，大多数患者需行甲状腺素治疗。甲状腺髓样癌的主要治疗方法也是手术，对于无法手术切除的复发性或持续性疾病，某些患者可能适合应用激酶抑制剂。间变性甲状腺癌几乎均为致命性疾病，不能进行碘 131 成像和放射性碘治疗。当需要全身治疗时，首选靶向治疗方案。本文介绍了 NCCN 关于甲状腺髓样癌和间变性甲状腺癌的管理建议，以及分化型甲状腺癌（乳头状癌、滤泡状癌、Hurthle 细胞癌）的手术治疗方法。
