中国癌症杂志 ›› 2025, Vol. 35 ›› Issue (10): 941-945.doi: 10.19401/j.cnki.1007-3639.2025.10.006

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《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读:分化型甲状腺癌的外照射放疗进展

刘晓亮(), 侯晓荣()   

  1. 中国医学科学院北京协和医学院北京协和医院放射治疗科,北京 100730
  • 收稿日期:2025-09-12 修回日期:2025-10-21 出版日期:2025-10-30 发布日期:2025-11-19
  • 通信作者: 侯晓荣
  • 作者简介:刘晓亮(ORCID: 0000-0002-8867-344X),博士,主治医师。
    侯晓荣,肿瘤学博士,主任医师,硕士研究生导师,北京协和医院放疗科副主任。现任中华医学会放射肿瘤治疗学分会第十届委员会青年学组委员,中国医师协会放射肿瘤治疗医师分会青年委员会副主任委员,中国临床肿瘤学会甲状腺癌临床研究协作组常务委员、妇科肿瘤专家委员会委员,中国研究型医院学会放射肿瘤学专业委员会常务委员,中国医学装备协会放射治疗装备技术分会常务委员,北京医学会放射肿瘤治疗学分会第十一届委员,北京医师协会放射治疗专科医师(技师)分会理事。以第一作者或通信作者身份在SCI收录期刊上发表论文多篇。参与及主持首都医学发展科研基金、科技部十三五/十四五国家重点研发项目及中国医学科学院临床转化基金等课题。获中华医学科技三等奖1项,北京医学科技二等奖1项。
  • 基金资助:
    北京协和医院协和人才培育支持计划C类(UBJ04712);十四五国家重点研发计划临床研究及验证评价(2023YFC2411504)

Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: progress in external beam radiotherapy (EBRT) for differentiated thyroid cancer

LIU Xiaoliang(), HOU Xiaorong()   

  1. Department of Radiation Oncology, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2025-09-12 Revised:2025-10-21 Published:2025-10-30 Online:2025-11-19
  • Contact: HOU Xiaorong
  • Supported by:
    Peking Union Medical College Hospital Talent Cultivation Program (Category C)(UBJ04712);National Key R&D Program of China, Ministry of Science and Technology of the People’s Republic of China(2023YFC2411504)

摘要:

外照射放疗(external beam radiotherapy,EBRT)是头颈部恶性肿瘤的重要治疗手段之一,但其在成人分化型甲状腺癌(differentiated thyroid cancer,DTC)中的应用长期以来存在争议。近年来,多种新兴的放疗技术,如调强放疗(intensity-modulated radiotherapy,IMRT)、立体定向放疗(stereotactic body radiotherapy,SBRT)等,在DTC的治疗中得到了广泛应用,并取得了显著的治疗效果。2025年,美国甲状腺学会(American Thyroid Association,ATA)更新并发布了《2025版成人分化型甲状腺癌管理指南》(简称2025年版ATA指南)。与2015年版ATA指南相比,2025年版ATA指南关于EBRT的推荐相对更加积极,强调了现代放疗技术在DTC个体化治疗上的适应证适用原则,特别是添加了对EBRT在“寡转移”治疗方面的推荐,并将SBRT纳入称为DTC的治疗选项。本文对2015年版与2025年版ATA指南进行对比分析,将2025年版ATA指南的EBRT部分进行系统性解读,为成人DTC的临床放疗实践提供循证医学证据。

关键词: 分化型甲状腺癌, 外照射放疗, 寡转移, 调强放疗, 立体定向放疗, 指南解读

Abstract:

External beam radiotherapy (EBRT) is one of the important treatment methods for head and neck malignant tumors. However, EBRT in differentiated thyroid cancer (DTC) has remained controversial for decades. In 2025, the American Thyroid Association (ATA) updated its clinical practice guidelines for the management of DTC in adults, which is known as the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer (abbreviation ATA guideline). In recent years, various emerging radiotherapy techniques, such as intensity modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT), have been applied in DTC and have achieved positive results. Compared with the 2015 ATA guideline, the revised guidelines adopt a more permissive perspective on EBRT, underscoring the importance of modern radiotherapy techniques and individualized indications. Notably, the recommendations now include the use of EBRT in the management of oligometastatic disease or SBRT. This article compared the2025 ATA guideline with 2015 ATA guideline, then provides a systematic interpretation of the section on EBRT, aiming to provide evidence-based foundation for clinical practice.

Key words: Differentiated thyroid cancer, External beam radiotherapy, Oligometastasis, Intensity-modulated radiotherapy, Stereotactic body radiotherapy, Guideline interpretation

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