按需的L-thyroxine替代疗法在乳腺切除术后的乳头状甲状腺癌中:一个前性的非随机对照研究
Siyuan Xu1, Lida Liao2, Keyao Xian2
1Department of Otolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
International journal of surgery (London, England)
|November 10, 2025
概括
在皮囊切除术后,对皮囊甲状腺癌患者的按需L-甲状腺素治疗使大多数患者能够避免补充剂. 与标准TSH抑制相比,这种方法保持了类似的无复发生存率和治疗反应.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 甲状腺癌研究研究
背景情况:
- 人们越来越多地质疑TSH抑制治疗乳头甲状腺癌 (PTC) 术后的必要性.
- 这项研究评估了这些患者的按需L-甲状腺素替代策略.
研究的目的:
- 评估按需的L-thyroxine疗法的有效性和安全性,在患有低至中等风险的PTC患者中进行带切除术后.
- 将治疗结果与接受标准TSH抑制治疗的历史对照进行比较.
主要方法:
- 预期的成年患者队列低至中等风险的PTC接受叶片切除 (2021-2023).
- 只有当血清TSH超过5.91 mU/L时,才可以使用L-甲状腺素.
- 与追溯对照 (2000-2014) 进行TSH 0.5-2 mU/L 的比较.
主要成果:
- 在手术后一年的潜在队列中,没有检测到需要L-甲状腺素的提升TSH.
- 预期组中的72.3%的患者不需要补充L-甲状腺素.
- 与历史对照相比,两年无复发生存期 (RFS) 或生化反应没有显著差异.
结论:
- 按需的L-thyroxine疗法使大约四分之三的脑膜切除术后PTC患者能够避免补充剂.
- 这一策略保持了相当的短期治疗反应和RFS.
- 按需治疗为选择的PTC患者提供了对TSH抑制的可行替代方案.
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