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2017 ; 18
(6
): ä Nephropedia Template TP
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Differentiated Thyroid Cancer-Treatment: State of the Art
#MMPMID28629126
Schmidbauer B
; Menhart K
; Hellwig D
; Grosse J
Int J Mol Sci
2017[Jun]; 18
(6
): ä PMID28629126
show ga
Differentiated thyroid cancer (DTC) is a rare malignant disease, although its
incidence has increased over the last few decades. It derives from follicular
thyroid cells. Generally speaking, the prognosis is excellent. If treatment
according to the current guidelines is given, cases of recurrence or persistence
are rare. DTC requires special expertise by the treating physician. In recent
years, new therapeutic options for these patients have become available. For this
article we performed a systematic literature review with special focus on the
guidelines of the American Thyroid Association, the European Association of
Nuclear Medicine, and the German Society of Nuclear Medicine. For DTC, surgery
and radioiodine therapy followed by levothyroxine substitution remain the
established therapeutic procedures. Even metastasized tumors can be cured this
way. However, in rare cases of radioiodine-refractory tumors, additional options
are to be discussed. These include strict suppression of thyroid-stimulating
hormone (also known as thyrotropin, TSH) and external local radiotherapy.
Systemic cytostatic chemotherapy does not play a significant role. Recently,
multikinase or tyrosine kinase inhibitors have been approved for the treatment of
radioiodine-refractory DTC. Although a benefit for overall survival has not been
shown yet, these new drugs can slow down tumor progression. However, they are
frequently associated with severe side effects and should be reserved for
patients with threatening symptoms only.
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