A Matter of Controversy: Is Radioiodine Therapy Favorable in Differentiated Thyroid Carcinoma?

A Matter of Controversy: Is Radioiodine Therapy Favorable in Differentiated Thyroid Carcinoma?
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一个有争议的问题:放射性碘治疗对分化型甲状腺癌是否有利?

DOI:
10.2967/jnumed.117.191338
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发表时间:
2018
期刊:
The Journal of Nuclear Medicine
影响因子:
--
通讯作者:
M. Dietlein
M. Dietlein
中科院分区:
--
文献类型:
--
作者:
M. Schmidt;R. Görges;A. Drzezga;M. Dietlein

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放射性碘治疗是一个有争议的问题,因为对其用于分化型甲状腺癌存在不同的看法。下面的文章阐明了不同的观点,并解释了为什么我们提倡不仅仅对高危患者使用放射性碘治疗。与其他恶性肿瘤相比,分化型甲状腺癌由于其通常生长缓慢的模式而具有不同的肿瘤生物学特性。放射性碘疗法于大约 75 年前首次使用,并在前瞻性随机对照试验尚未开展时提供了治愈方法。需要大量患者队列和通常至少十年的临床随访才能证明放射性碘治疗的益处。因此,特别是在低风险患者中,许多因素决定了个体治疗决策,包括肿瘤分期、手术范围、肿瘤生物学、临床和影像数据、预期寿命和患者偏好。
Radioiodine therapy is a matter of controversy because different opinions exist about its use for differentiated thyroid carcinoma. The following article sheds light on the different opinions and explains why we advocate the use of radioiodine therapy in more than only high-risk patients. In comparison to other malignancies, differentiated thyroid carcinoma has a different tumor biology due to its usually slow growth pattern. Radioiodine therapy was first used about 75 y ago and provided cure at a time when prospective randomized controlled trials had yet to be developed. Large patient cohorts and usually at least a decade of clinical follow-up are needed to demonstrate a benefit from radioiodine therapy. Thus, especially in low-risk patients, many factors define an individual treatment decision, including tumor stage, extent of surgery, tumor biology, clinical and imaging data, life expectancy, and patient preferences.
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