Thyroid hormone treatment of differentiated thyroid cancer: Reflection on current practices
10.3760/cma.j.cn311282-20200922-00651
- VernacularTitle:分化型甲状腺癌的甲状腺激素治疗：当前实践的反思
- Author:
Wenjing NI
1
;
Shuhang XU
;
Chao LIU
Author Information
1. 南京中医药大学附属中西医结合医院（江苏省中西医结合医院）内分泌科 210028
- Keywords:
Differentiated thyroid cancer;
Thyrotropin;
Thyroid hormone therapy
- From:
Chinese Journal of Endocrinology and Metabolism
2021;37(8):760-763
- CountryChina
- Language:Chinese
-
Abstract:
Thyroid hormone therapy is the mainstay of differentiated thyroid cancer (DTC) management after surgery. By controlling thyrotropin within target levels, it hopes that patients could restore euthyroidism state and lower recurrence rates. However, thyroid hormone treatment has been facing challenges in termso of lenefit-risk assessment since the improved risk stratification system of persistent/recurrent disease was into use. Clinicians should weigh the potential benefits against downsides based on initial risk of disease and ongoing risk assessment of disease status. The optimal TSH level for patients with an intermediate- or high-risk for recurrence is to maintain the beneficial effects on tumor recurrence without increasing the risk of adverse events. Levothyroxine should be titrated to avoid excessive TSH suppression for low-risk patients. Only with holistic benefit-risk analysis of thyroid hormone therapy, can we further promote the quality of postoperative DTC management.
