关键词: 碘难治性分化型甲状腺癌, 靶向治疗, 局部治疗, 诱导分化

Abstract: Treatment strategies for distant metastasis in radioiodine-refractory thyroid cancer        ZHANG Ya-jing, GAO Zai-rong.  Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Corresponding author: GAO Zai-rong, E-mail: gaobonn@163.com
Abstract    The incidence of thyroid cancer has increased year by year, and the incidence-based mortality trends have increased slowly. Radioiodine therapy is one of the standard therapies for differentiated thyroid cancer with distant metastasis. If the metastasis has no response or poor response for radioiodine therapy, the patients could be identified as radioiodine-refractory differentiated thyroid cancer(RR-DTC), with a low possibility of benefiting from subsequent single 131I therapy. Some RR-DTC cases with distant metastasis  progress rapidly, which is tough in clinical diagnosis and further treatment. In recent years, the deepening exploration of molecular biology technology in the field of thyroid cancer has promoted the application of precise diagnosis and treatment based on molecular features in this field. Based on these advancements, active surveillance with TSH suppression, surgical treatment, local treatment, targeted therapy, targeted combination therapy with 131I, targeted combination immunotherapy, and other comprehensive treatment measures can be used for the treatment of distant metastases in RR-DTC. PRRT guided by nuclear medical molecular imaging may provide new hope for RR-DTC patients who have failed targeted treatments.

Key words: radioiodine-refractory differentiated thyroid cancer, targeted therapy, local treatment, induction of differentiation