在患有低风险和中等风险的甲状腺 papillary carcinoma 的患者中,术后放射性治疗的有效性
Hyeon A Lee1, Chang Myeon Song1, Yong Bae Ji1
1Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Endocrine
|September 23, 2024
概括
手术后放射性 (RAI) 治疗对大多数低至中等风险的乳头甲状腺癌 (PTC) 患者的复发和生存的影响有限. 然而,RAI可能会使特定的亚组受益,包括晚期淋巴结参与的老年患者.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 核医学就是核医学.
背景情况:
- 乳头甲状腺癌 (PTC) 是最常见的甲状腺癌类型.
- 风险分层对于指导治疗决策至关重要,包括使用放射性 (RAI).
- 术后RAI在低至中等风险PTC中的作用仍然是调查的主题.
研究的目的:
- 为了评估术后放射性 (RAI) 治疗的疗效.
- 评估RAI对复发率和生存益处的影响.
- 分析患有低至中等风险乳头甲状腺癌 (PTC) 的患者的这些影响.
主要方法:
- 对1286名低至中等风险PTC患者的回顾性分析.
- 患者接受了全甲状腺切除术,包括或不包括部解剖.
- 在2000年至2021年期间,接受术后RAI和未接受RAI的患者之间的比较.
主要成果:
- 在低风险和中等风险类别中,RAI和非RAI组的总生存率和无疾病生存率相似.
- 在55岁以上的中等风险患者中,术后的RAI显著降低了复发率,这些患者患有PN1b疾病 (HR 0.043) 和具有≥5个转移性淋巴结的患者 (HR 0.060).
结论:
- 在大多数低至中等风险的PTC患者中,术后RAI不会显著改变复发或存活率.
- 对于特定的亚组来说,RAI可能会带来好处,特别是患有晚期结节病 (pN1b) 或多种转移性淋巴结的老年患者.
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