Barbaro D, Giani C, Lapi P, Profilo M, Forleo R, Rosada J, Basili G, Materazzi G
U.O. Endocrinology ASL Nord-West, Spedali Riuniti, Livorno, Italy.
U.O Internal Medicine ASL Nord-West, Spedali Riuniti, Livorno, Italy.
Endocrine. 2025 Feb 4. doi: 10.1007/s12020-025-04182-2.
To analyse the literature on the potential role of kinase inhibitors (KI) as neoadjuvant treatment (NAT) in all thyroid cancers (TC).
Online databases were systematically examined, including MEDLINE (via PubMed) Embase, ISI Web of Science, Google Scholar, and Scopus. As many papers were published before the classification of TC was revised, our search was conducted as follows: NAT in TC, NAT in papillary thyroid cancer (PTC), NAT in follicular thyroid cancer (FTC), NAT in anaplastic thyroid cancer (ATC), and NAT in medullary thyroid cancer (MTC).
The search revealed 21 single case reports and three small series on NAT in TC. Overall, 32 cases were found: 24 follicular cell derived cancers (FCDC) of which nine were ATC, eight were MTC. We also found four major retrospective series, in two of which the cohort was divided and analysed into different groups according to the kind of treatment. In these four series, NAT was performed in in a total of 99 patients (32 FCDC, 60 ATC, and 7 MTC).
While awaiting large-scale clinical trials, the literature highlights that NAT may be an option for locally advanced TC (and above all ATC) when surgery may be too destructive or when the tumour is inoperable. The use of NAT should be discussed with the patient. An R0 or at least an R1 should be the goal of NAT, and the molecular profile should be performed as rapidly as possible.
分析关于激酶抑制剂（KI）作为所有甲状腺癌（TC）新辅助治疗（NAT）潜在作用的文献。
系统检索在线数据库，包括MEDLINE（通过PubMed）、Embase、ISI Web of Science、谷歌学术和Scopus。由于许多论文在TC分类修订之前发表，我们的检索按以下方式进行：TC中的NAT、乳头状甲状腺癌（PTC）中的NAT、滤泡状甲状腺癌（FTC）中的NAT、未分化甲状腺癌（ATC）中的NAT以及髓样甲状腺癌（MTC）中的NAT。
检索发现21篇关于TC中NAT的单病例报告和3个小系列研究。总体而言，共发现32例：24例滤泡细胞源性癌（FCDC），其中9例为ATC，8例为MTC。我们还发现4个主要的回顾性系列研究，其中2个系列根据治疗类型将队列进行分组和分析。在这4个系列研究中，共有99例患者接受了NAT（32例FCDC、60例ATC和7例MTC）。
在等待大规模临床试验的同时，文献强调当手术可能具有过大破坏性或肿瘤无法手术切除时，NAT可能是局部晚期TC（尤其是ATC）的一种选择。应与患者讨论NAT的使用。NAT的目标应为R0切除或至少R1切除，并且应尽快进行分子特征分析。
