Brierley J D, Tsang R W
Department of Radiation Oncology, University of Toronto, Ontario Cancer Institute/Princess Margaret Hospital, Canada.
Semin Surg Oncol. 1999 Jan-Feb;16(1):42-9. doi: 10.1002/(sici)1098-2388(199901/02)16:1<42::aid-ssu8>3.0.co;2-4.
The role of external-beam radiation therapy (EBRT) in differentiated thyroid cancer is reviewed. In the presence of gross residual disease after attempted surgical excision, retrospective series have reported local control is possible with EBRT. If, in addition to Iodine-131 (I131), there is a role for adjuvant EBRT in differentiated thyroid cancer, it would be only in patients in whom there is a high risk of relapse in the thyroid bed. Evidence is presented that suggests that EBRT can improve the local relapse-free rate in selected patients (over the age of 45, with microscopic residual disease or extensive extrathyroid invasion). For patients with recurrence in the thyroid bed, EBRT can be given in addition to surgery and I131. In bone metastases that are demonstrable radiographically, I131 therapy is often unsuccessful and EBRT also should be given. The technique of thyroid bed radiation is described. EBRT has acceptable acute toxicity and rarely produces serious long-term complications.
本文回顾了外照射放射治疗（EBRT）在分化型甲状腺癌中的作用。在手术切除后存在肉眼可见的残留病灶时，回顾性系列研究报告称EBRT可实现局部控制。如果除了碘-131（I131）之外，辅助性EBRT在分化型甲状腺癌中还有作用，那也仅适用于甲状腺床复发风险高的患者。有证据表明，EBRT可提高部分患者（年龄超过45岁、有微小残留病灶或广泛甲状腺外侵犯）的局部无复发生存率。对于甲状腺床复发的患者，除手术和I131治疗外，还可给予EBRT。对于影像学检查可证实的骨转移，I131治疗往往无效，也应给予EBRT。本文还描述了甲状腺床放疗技术。EBRT具有可接受的急性毒性，很少产生严重的长期并发症。
