分化型甲状腺癌的复发治疗  

Treatment of recurrent disease in differentiated thyroid cancer

作　　者：张浩[1] 项敬哲 孙威[1] ZHANG Hao;XIANG Jingzhe;SUN Wei(Department of Thyroid Surgery,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院甲状腺外科,辽宁沈阳110001

出　　处：《西安交通大学学报（医学版）》2024年第1期23-27,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：分化型甲状腺癌预后良好,但仍有5%~20%的患者在初次治疗后出现复发,造成患者身心和经济上的负担,同时也给临床医师对甲状腺癌的诊疗带来困难。与初始治疗方案不同,对复发甲状腺癌的处理应综合考虑风险与获益等因素。手术仍是首选治疗方式,对具有摄碘功能的复发病灶推荐放射性碘治疗,而体积较小的复发病灶可暂行主动监测,热消融治疗应仅限于不适合再次手术治疗的患者。当其他治疗方案无效时,可考虑辅助性外照射治疗或系统治疗。Differentiated thyroid cancer usually has a good prognosis;however,recurrence occurs in 5%to 20%of patients after initial treatment,which causes physiopsychological and financial burdens for the patients.In the meantime,it complicates the treatment decision-making for clinicians.Different from initial treatment,the management of recurrent thyroid cancer should take comprehensive consideration of factors such as risks and benefits.Surgery is considered to be the first choice of treatment while radioactive iodine therapy is recommended for radioiodine-avid recurrent disease.Smaller lesions can be managed with active surveillance temporarily,and thermal ablation should only be applied to patients not suitable for additional surgery.In contrast,external beam radiotherapy and systemic therapies are considered only after all therapy options have been exhausted.

关 键 词：分化型甲状腺癌 复发 治疗 手术 放射性碘治疗 

分 类 号：R736.1[医药卫生—肿瘤]