Usefulness of local therapy for distant metastases of differentiated thyroid cancer.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

European Thyroid Journal Pub Date : 2025-06-11 Print Date: 2025-06-01 DOI:10.1530/ETJ-24-0237

Sueyoshi Moritani, Masao Takenobu, Masakazu Yasunaga, Taihei Fujii, Hiroya Kitano

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引用次数: 0

Abstract

Objective: Treatment for distant metastases (DM) of differentiated thyroid cancer (DTC) aims to improve the prognosis and quality of life (QOL). Radioactive iodine and molecular targeted therapies are the primary systemic treatments for DM. Combining these with local treatments, such as surgery and radiotherapy targeting metastatic sites, may provide additional benefits to systemic therapy.

Methods: This study reviewed the additional effects of local therapies on common metastatic sites of DTC, such as pulmonary or bone metastases (BM), the efficacy of bone-modifying agents (BMAs) for BM, and the therapeutic effects of local treatments for less common brain metastases.

Results: Although based on retrospective studies with no definitive conclusions on the effectiveness of each treatment, local therapy for DM in DTC patients has been shown to enhance prognosis and QOL in several studies. Considering the results of clinical trials for metastatic tumors, local therapy for one or a few pulmonary or BM in DTC should be considered, if expected to improve prognosis and QOL. Surgical intervention is recommended for spinal metastases presenting with spinal compression symptoms or for long BM in extremities at risk of pathological or impending fractures. BMAs are also recommended to reduce the risk of skeletal-related events. Surgery, stereotactic radiotherapy, and whole-brain radiotherapy are suggested for brain metastases to improve the prognosis and QOL.

Conclusion: Incorporating local therapy alongside systemic treatment can enhance the prognosis and QOL and should be considered a viable treatment option.

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分化性甲状腺癌远处转移局部治疗的有效性。

目的：分化型甲状腺癌（DTC）远处转移（DM）的治疗旨在改善预后和生活质量（QOL）。放射性碘和分子靶向治疗是糖尿病的主要全身治疗方法。将这些与局部治疗相结合，如针对转移部位的手术和放疗，可能会为全身治疗提供额外的益处。方法：本研究回顾了局部治疗对DTC常见转移部位的额外作用，如肺或骨转移（BM），骨修饰剂（BMAs）对BM的疗效，以及局部治疗对不太常见的脑转移的治疗效果。结果：虽然基于回顾性研究，对每种治疗方法的有效性没有明确的结论，但在一些研究中，DTC患者DM的局部治疗已被证明可以改善预后和生活质量。考虑到转移性肿瘤的临床试验结果，如果期望改善预后和生活质量，应考虑局部治疗DTC中的一个或几个肺或BM。对于出现脊柱压迫症状的脊柱转移瘤，或有病理性骨折或即将发生骨折风险的四肢长骨转移瘤，建议进行手术干预。bma还被推荐用于降低骨骼相关事件的风险。对于脑转移瘤，建议手术、立体定向放疗和全脑放疗，以改善预后和生活质量。结论：局部联合全身治疗可提高预后和生活质量，是一种可行的治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.