甲状腺未分化癌的综合治疗

病人均行全甲状腺切除及双侧中央组淋巴结清扫，术中一并切除甲状旁腺并行自体移植，其中2例（2.4%）发现淋巴结转移，术后3例（3.5%）发生甲状旁腺功能减退［9］。

不同MTC病例的恶性程度差异较大，有些可多年稳定，甚至呈隐匿状态，有些侵袭性强、病死率高。总体而言，MTC相关的10年存活率为75%。主要的预后因素包括诊断时年龄、原发病灶大小、有无淋巴转移和远处转移。按照TNM分期，Ⅰ、Ⅱ、Ⅲ和Ⅳ期的10年存活率分别为100%、93%、71%和21%。但MTC早期即易淋巴和血运转移，使大多数病人诊断时已是Ⅲ期或Ⅳ期，近年来的医学技术发展并未改善他们的预后［10-12］。随着人们对甲状腺疾病的重视，对MTC认识的加深及基因测序技术的开展，早期诊断、预防手术逐步成为可能。彻底精细的手术仍是MTC最主要的治疗方式。而靶向治疗的方兴未艾，也给晚期MTC病人带来了希望的曙光［13-14］。

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（2011-02-20收稿）文章编号：1005-2208（2011）05-0401-04

甲状腺未分化癌的综合治疗

何霞云

【摘要】甲状腺未分化癌是临床少见而发展快速的高度恶性肿瘤。调强放疗有利于局部病灶的控制，改善病人的生存质量。多个肿瘤中心在探索手术、放疗、化疗的综合治疗。

【关键词】甲状腺未分化癌；放射治疗；化学治疗

中图分类号：R6文献标志码：A

Multimodal treatment of anaplastic thyroid carcinoma HE Xia-yun.Department of Radiation Oncology,Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College of Fudan University,Shanghai 200032,China

Abstract Anaplastic thyroid carcinoma is a rare thyroid tumor with a very aggressive clinical course.Intensity modulated radiotherapy(IMRT)techniques might be beneficial to local control.Multimodal treatment of surgical resection,radiotherapy and chemotherapy have been studied. Further clinical trials are required to define optimal therapy.

作者单位：复旦大学附属肿瘤医院放射治疗科复旦大学上海医学院肿瘤学系，上海200032

E-mail：hexiayun1120@