New directions in the treatment of thyroid cancer.
New directions in the treatment of thyroid cancer.
复制标题
甲状腺癌治疗的新方向。
DOI：
10.1016/j.jamcollsurg.2007.06.323
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发表时间：
2007
影响因子：
5.2
通讯作者：
WellsJr,SamuelA
中科院分区：
文献类型：
--
作者：
You,YNancy;Lakhani,Vipul;WellsJr,SamuelA
最近发现的关键致癌事件导致甲状腺癌的治疗这些日益常见的恶性肿瘤的重大进展。这篇文章突出了两个这样的进步。首先，预防性甲状腺切除术已被证明是有效的预防或治疗遗传性甲状腺髓样癌（MTC）的年轻患者。第二，针对已知致癌途径进行合理设计的小分子化合物目前正在临床试验中，对局部晚期或转移性甲状腺癌患者有希望。遗传性甲状腺癌的预防性手术近25%的MTC是遗传性的，发生于多发性内分泌瘤（MEN）2A型（60%），MEN 2B型（5%），或家族性甲状腺髓样癌（FMTC，35%）。1甲状腺髓样癌是这些患者中最常见的死亡原因。晚期患者无法治愈，因为常规化疗或放疗对MTC无效。因此，最佳治疗需要早期发现和干预。
Recent discoveries of the key oncogenic events causing thyroid cancer have led to major advances in the treatment of these increasingly common malignancies. This article highlights two such advances. First, prophylactic thyroidectomy has proven effective in preventing or curing hereditary medullary thyroid carcinoma (MTC) in young patients. Second, small molecule compounds, rationally designed to target known oncogenic pathways, are currently in clinical trials, and hold promise for patients with locally advanced or metastatic thyroid cancer.Prophylactic surgery in hereditary thyroid cancer Nearly 25% of all MTC is hereditary and occurs with either multiple endocrine neoplasia (MEN) type 2A (60%), MEN type 2B (5%), or familial medullary thyroid carcinoma (FMTC, 35%). 1 Medullary thyroid cancer is the most common cause of death in these patients. Patients with advanced disease are incurable as conventional chemotherapy or radiotherapy for MTC is ineffective. Optimal therapy, therefore, requires early detection and intervention.