甲状腺癌
医学
甲状腺
放射性碘
甲状腺结节
近距离放射治疗
癌症
放射治疗
外科
医学物理学
内科学
出处
期刊:PubMed
日期:2023-01-17
卷期号:103 (3): 149-157
标识
DOI:10.3760/cma.j.cn112137-20220905-01873
摘要
Iodine-125 seed implantation therapy provides an alternative method for persistent or recurrent thyroid cancer that cannot be operated again, cannot be controlled by iodine-131 therapy and is not suitable for targeted therapy, which is characterized by precise efficacy, safe and minimally invasive. However, due to the complex anatomical structure of the neck and the variable location of the target, the puncture path is limited, and sometimes it is difficult to meet the requirements of dosimetry or achieve homogenization, which seriously affects the efficacy and poses a great challenge to the promotion of this technique. In order to improve the level of comprehensive treatment for thyroid cancer, and better regulate the operation technology of radioactive iodine-125 seed implantation for thyroid cancer, led by the Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association and Committee of Experts on radioactive particle implantation, Chinese Medical Doctor Association, the "Chinese expert consensus on Iodine-125 Seed Implantation for locally advanced differentiated thyroid cancer(2022 Edition)" was formulated, and the indications, contraindications, implantation methods, puncture paths, preoperative preparation, surgical procedures, surgical difficulties, adverse reactions, follow-up and other content of iodine-125 seed implantation for the treatment of differentiated thyroid cancer were introduced in detail, so as to provide reference for clinical practice.碘-125粒子植入治疗为不能再次手术、碘-131治疗不可控及不适合靶向治疗的持续或复发甲状腺癌提供了一种可选择的手段,具有疗效确切、安全微创的特点。但由于颈部解剖结构较为复杂,靶区位置多变,使得穿刺路径有限,有时难以满足剂量学要求,也难以达到同质化,严重影响疗效,对该技术的推广带来了巨大的挑战。为提高甲状腺癌综合治疗的水平,更好地规范放射性碘-125粒子植入治疗甲状腺癌的操作技术,由中国抗癌协会肿瘤微创治疗专业委员会、中国医师协会放射性粒子植入技术专家委员会牵头,制定了“放射性碘-125粒子植入治疗局部晚期分化型甲状腺癌中国专家共识2022版”,详细介绍了碘-125粒子治疗分化型甲状腺癌的适应证、禁忌证、植入方式、穿刺路径、术前准备、手术流程、手术难点、不良反应、随访等内容,以便为临床实践提供参考。.
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