临床肿瘤学杂志

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精确放疗治疗甲状腺癌的研究进展

吴长华1,韩大力2,王亮1,陈万军1   

  1. 1 济南大学 山东省医学科学院医学与生命科学学院 山东省肿瘤防治研究院头颈外科 2 山东省肿瘤防治研究院放疗二病区
  • 收稿日期:2015-11-18 修回日期:2016-02-18 出版日期:2016-07-30 发布日期:2016-07-30
  • 通讯作者: 陈万军

Progress of accurate radiotherapy in thyroid cancer

WU Changhua, HAN Dali, WANG Liang, CHEN Wanjun.   

  1. School of Medicine and Life Science, University of Jinan, Shandong Academy of Medical Sciences
  • Received:2015-11-18 Revised:2016-02-18 Online:2016-07-30 Published:2016-07-30
  • Contact: CHEN Wanjun

摘要: 甲状腺癌是最常见的内分泌系统恶性肿瘤,按组织病理类型可以分为乳头状甲状腺癌、滤泡状甲状腺癌、髓样甲状腺癌和未分化型甲状腺癌。前两者因分化水平较高统称为分化型甲状腺癌。分化型甲状腺癌首选手术治疗,其次针对术中未能切除的残余病灶进行放射碘治疗。外照射放疗在分化型甲状腺癌及甲状腺髓样癌中的作用仅局限于手术治疗失败、肿瘤不能切除或者有肉眼可见远处转移灶残留的患者。精确放疗可增加肿瘤的局部控制率,减少正常组织的放射损伤。而甲状腺未分化癌大多数不能完全手术切除,外照射放疗联合化疗具有重要作用。放疗作为术前、术后综合治疗的一部分发挥作用,也可以采用单纯放疗的形式缓解症状、控制病变生长,从而延长生存期,起到姑息治疗的目的。

Abstract: Thyroid carcinoma is the most common malignant tumor of the endocrine system, which can be divided into four kinds according to the pathological type: papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and undifferentiated thyroid cancer. The first two are known together as differentiated thyroid cancer due to the high level of differentiation. The initial management of differentiated thyroid cancer is surgery, followed by radioactive iodine for gross residual or unresectable disease. For both differentiated thyroid cancer and medullary thyroid cancer, the role of external beam radiotherapy after resection of gross disease when there is a high risk of local regional failure is reviewed. Accurate radiotherapy can reduce the risk of the local recurrence and the radiation injury to normal tissue. In anaplastic thyroid cancer, although most patients present with unresectable disease and radiotherapy is the mainstay of treatment, the benefits of the addition of chemotherapy to radiation therapy will be discussed. External beam radiotherapy not only plays a role as a part of combined treatment of preoperative and postoperative, but also can be used separately to alleviate symptoms, control the growth of the lesion and prolong the overall survival to serve the purpose of palliative treatment.

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