在高剂量疗法中管理延迟甲状腺脱的共识:来自中东的见解
Mubarak Al Manasour1,2, Ahmad Absi1, Ahmad Alhuraiji3,4
1Adult Medical Oncology, Princess Noorah Oncology Center, Jeddah, Saudi Arabia.
Frontiers in oncology
|November 24, 2025
概括
这一共识提供了安全的高剂量甲状腺素 (HDMTX) 治疗的临床策略,重点是通过标准化监测和支持性护理来预防延迟甲状腺素排泄和损伤.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 高剂量甲状腺素 (HDMTX) 对于治疗儿科和成人癌症至关重要,因为它能穿透血脑屏障.
- HDMTX携带延迟甲状腺素排泄 (DME) 和急性损伤 (AKI) 的风险,需要谨慎管理.
- 个性化剂量和预防策略,如过水和leucovorin救援,对于减轻HDMTX毒性至关重要.
研究的目的:
- 制定基于共识的临床指南,用于管理HDMTX相关的毒性.
- 为了优化HDMTX的管理和改善患者在瘤学的结果.
主要方法:
- 采用了经过修改的Delphi方法,涉及两轮专家共识.
- 来自中东的13位瘤专家就HDMTX治疗方案,风险因素和管理提出了54份声明.
- 在50个陈述上达成共识 (≥75%).
主要成果:
- 对于甲状腺酸盐的标准化监测间隔达成共识.
- 建议包括对DME和AKI进行结构化风险评估,强调支持性护理.
- 这些指导方针涵盖了药理学上调整的leucovorin救援和葡萄糖酶在严重病例中的作用.
结论:
- 该共识为安全和有效的HDMTX使用提供了可行的策略.
- 关键建议包括对DME的风险分层,标准化监测和指导性白血救援.
- 这些指导方针对于在资源有限的环境中优化HDMTX治疗尤为重要.
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