CAJ | 학술논문

儿童及青少年DTC发病率较低,预后相对较好,但与成人相比,其侵袭性更强,复发率相对较高.DTC患儿在手术切除后辅以131I治疗可以有效减少复发的风险.对于大多数DTC患儿,全或近全甲状腺切除加中央区淋巴结清扫可作为推荐术式.DTC患儿术后应行131I治疗以清除残留甲状腺组织,降低肿瘤复发的风险.大剂量131I治疗可能增加患者罹患其他实体第二原发恶性肿瘤的风险.笔者推荐对已接受手术及131I治疗后的DTC患儿长期密切随访,以及时发现肿瘤复发;同时采取多学科合作及个体化治疗方案,尽可能减少不良反应.
인동급청소년DTC발병솔교저,예후상대교호,단여성인상비,기침습성경강,복발솔상대교고.DTC환인재수술절제후보이131I치료가이유효감소복발적풍험.대우대다수DTC환인,전혹근전갑상선절제가중앙구림파결청소가작위추천술식.DTC환인술후응행131I치료이청제잔류갑상선조직,강저종류복발적풍험.대제량131I치료가능증가환자리환기타실체제이원발악성종류적풍험.필자추천대이접수수술급131I치료후적DTC환인장기밀절수방,이급시발현종류복발;동시채취다학과합작급개체화치료방안,진가능감소불량반응.
DTC in pediatric and adolescent patients has lower incidence and is generally reported to have better prognosis.However,compared with DTC in adults,it is more aggressive and the recurrence rate is higher.Surgery and adjuvant radioiodine therapy can minimize the risk of recurrence.Total or near total thyroidectomy combined with central compartment lymph node dissection is the preferred surgical procedure for most of these patients.Radioiodine therapy for ablation of thyroidal remnant or residual disease is recommended in order to reduce the risk of tumor recurrence,but there is slight chance of increased risk of a sec ond primary malignancy (SPM).Long-term follow-up is therefore recommended for the pediatrics and adolescents with DTC after treatment.Multi-disciplinary collaborative management is needed to optimize treatment efficacy and to minimize adverse effects.