在低风险的乳头甲状腺癌的初级治疗中存在争议
Donald S A McLeod1, Anna M Sawka, David S Cooper
1Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Lancet (London, England)
|May 15, 2013
概括
在全球范围内,乳头甲状腺癌的发病率正在上升. 本综述审查了流行病学数据和管理指南,为这种常见的恶性瘤提供了治疗框架.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 内分泌学 在内分泌学.
背景情况:
- 全球乳头甲状腺癌的发病率正在迅速增加,这给临床带来了重大挑战.
- 虽然许多被诊断的病例是小的和低风险的,但有效的管理策略仍在争论中.
- 很难最终证明传统治疗三元组的益处,特别是在低风险疾病中.
研究的目的:
- 审查目前关于乳头甲状腺癌发病率的流行病学数据.
- 讨论关于治疗乳头甲状腺癌的争议.
- 根据现有证据和临床指南提出治疗框架.
主要方法:
- 对乳头甲状腺癌发病率的流行病学数据的系统审查.
- 分析现有的临床实践指南和管理策略的证据.
- 综合信息以创建治疗框架.
主要成果:
- 乳头甲状腺癌是全球增长最快的恶性瘤.
- 支持传统治疗三位一体 (手术,放射性,TSH抑制) 的证据有限,特别是在低风险疾病中.
- 临床实践指南存在,但由于缺乏随机对照试验而受到阻碍.
结论:
- 清楚地了解乳头甲状腺癌流行病学对于有效的管理至关重要.
- 风险分层和量身定制的治疗方法至关重要.
- 需要进一步的研究,包括随机对照试验,以完善管理准则并优化患者的治疗结果.
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