放射性抗分化甲状腺癌的系统治疗选择:当前的指示和最佳时机
Tamara Díaz Vico1,2, Brezo Martínez-Amores Martínez1,2, Luka Mihic Góngora3,4
1Department of General Surgery, Hospital Universitario Rey Juan Carlos, 28933 Madrid, Spain.
Cancers
|June 13, 2025
概括
耐放射性抗性甲状腺癌 (RAI-R TC) 需要全身治疗. 平衡治疗效益与毒性对于管理这种普遍的恶性瘤和改善患者生活质量至关重要.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 癌症研究 癌症研究
背景情况:
- 甲状腺癌 (TC) 是一种常见的恶性瘤,分化甲状腺癌 (DTC) 在手术和放射性 (RAI) 切除后具有良好的预后.
- 在5-15%的患者中,有一小部分患上RAI-R耐药性疾病 (RAI-R),与较差的结局有关.
- 对RAI-RTC的治疗以疾病进展为指导,从积极监测到全身疗法.
研究的目的:
- 审查当前的证据和临床指导方针,用于管理RAI耐火分化甲状腺癌.
- 讨论系统性疗法的作用,包括多酶抑制剂 (MKIs) 和新型向性药物.
- 突出治疗时间和毒性管理方面的挑战,以优化患者的生活质量.
主要方法:
- 关于RAI-RTC管理的当前证据的文献综述.
- 来自ATA和ESMO等组织的临床指南的综合.
- 系统性治疗选择的分析,包括MKI和新兴的向治疗.
主要成果:
- 渐进的RAI-RTC的第一线全身治疗包括lenvatinib和sorafenib等MKI;卡博赞提尼布已被批准用于耐药病例.
- 针对RET,NTRK和免疫检查点的新疗法正在研究中.
- 平衡MKI毒性与无进展生存的益处是影响生活质量的关键挑战.
结论:
- 在RAI-RTC中进行全身治疗的最佳时间非常重要,考虑到疾病进展和患者状态.
- 分子测试可以指导个性化治疗选择.
- 多学科的方法和仔细的毒性监测对于管理RAI-RTC和维持生活质量至关重要.
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