Spanish consensus for the management of patients with advanced radioactive iodine refractory differentiated thyroid cancer

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• 作者：Garcilaso Riesco-Eizaguirre^a ; ^{griesco@iib.uam.es" class="auth_mail" title="E-mail the corresponding author} ; Juan Carlos Galofré ; ^b ; Enrique Grande^c ; Carles Zafó ; n Llopis^d ; Teresa Ramó ; n y Cajal Asensio^e ; Elena Navarro Gonzá ; lez^f ; Paula Jimé ; nez-Fonseca^g ; Javier Santamarí ; a Sandi^h ; José ; Manuel Gó ; mez Sá ; ezⁱ ; Jaume Capdevila^j
• 关键词：Differentiated thyroid cancer ; Radioactive iodine refractory ; Spanish consensus ; Clinical management
• 刊名：Endocrinología y Nutrición
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：63
• 期：4
• 页码：e17-e24
• 全文大小：483 K

文摘

Approximately one third of the patients with differentiated thyroid cancer (DTC) who develop structurally-evident metastatic disease are refractory to radioactive iodine (RAI). Most deaths from thyroid cancer occur in these patients. The main objective of this consensus is to address the most controversial aspects of management of these patients.

Methods

On behalf of the Spanish Society of Endocrinology & Nutrition (SEEN) and the Spanish Group for Orphan and Infrequent Tumors (GETHI), the Spanish Task Force for Thyroid Cancer, consisting of endocrinologists and oncologists, reviewed the relevant literature and prepared a series of clinically relevant questions related to management of advanced RAI-refractory DTC.

Results

Ten clinically relevant questions were identified by the task force. In answering to these 10 questions, the task force included recommendations regarding the best definition of refractoriness; the best therapeutic options including watchful waiting, local therapies, and systemic therapy (e.g. kinase inhibitors), when sodium iodide symporter (NIS) restoration may be expected; and how recent advances in molecular biology have increased our understanding of the disease.

Conclusions

In response to our appointment as a task force by the SEEN and GHETI, we developed a consensus to help in clinical management of patients with advanced RAI-refractory DTC. We think that this consensus will provide helpful and current recommendations that will help patients with this disorder to get optimal medical care.