甲状腺癌脑转移的诊断与治疗
Diagnosis and management of brain metastasis from thyroid cancer.
作者信息
Cascio Vincent, Doerfler W Reed, Taneja Charit
机构信息
Division of Endocrinology, Diabetes, and Metabolism, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, New York, USA.
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
出版信息
Endocr Oncol. 2025 May 16;5(1):e250002. doi: 10.1530/EO-25-0002. eCollection 2025 Jan.
The brain is an uncommon location for metastatic spread from thyroid cancer. Given the rarity of the condition, the data regarding various management options for such patients are suboptimal. Radioactive iodine is seldom useful for brain metastases owing to variable uptake and unclear benefit. Surgical resection and stereotactic radiation remain the first-line treatment options for a limited number of brain metastases from thyroid cancer, as they not only provide local control and symptomatic relief but can also improve survival. Whole-brain radiation therapy has been used for patients with multiple brain metastases but has largely fallen out of favor due to the availability of more targeted and tolerable options. Systemic therapy with kinase inhibitors is a novel and promising area of research in this field, with an increased utilization of molecular testing to identify targetable mutations. Treatment plans for patients with brain metastases from thyroid cancer should be highly individualized and tailored to the specific patient by a multidisciplinary care team.
脑是甲状腺癌转移扩散的罕见部位。鉴于这种情况的罕见性,关于此类患者各种治疗选择的数据并不理想。由于摄取情况不一且益处不明确,放射性碘对脑转移瘤很少有用。手术切除和立体定向放射仍然是少数甲状腺癌脑转移瘤的一线治疗选择,因为它们不仅能提供局部控制和症状缓解,还能提高生存率。全脑放射治疗已用于有多发性脑转移瘤的患者,但由于有了更具针对性且耐受性更好的选择,它在很大程度上已不再受青睐。使用激酶抑制剂的全身治疗是该领域一个新的且有前景的研究领域,分子检测用于识别可靶向突变的应用有所增加。甲状腺癌脑转移瘤患者的治疗方案应高度个体化,并由多学科护理团队根据具体患者量身定制。