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

Xiaoliang LIU; Xiaorong HOU

doi:10.19401/j.cnki.1007-3639.2025.10.006

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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

Specialist's Commentary | 更新时间：2025-12-31

- 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
- China Oncology Vol. 35, Issue 10, Pages: 941-945(2025)
- 作者机构：
  
  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
- 作者简介：
- 基金信息：
  
  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)
- DOI：10.19401/j.cnki.1007-3639.2025.10.006
  CLC： R739.62
- Received：12 September 2025，
  
  Revised：2025-10-21，
  
  Published：30 October 2025
- 稿件说明：
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Xiaoliang LIU, Xiaorong HOU. 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[J]. China Oncology, 2025, 35(10): 941-945.
DOI：

Xiaoliang LIU, Xiaorong HOU. 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[J]. China Oncology, 2025, 35(10): 941-945. DOI： 10.19401/j.cnki.1007-3639.2025.10.006.

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。

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.

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references

HAUGEN B R , ALEXANDER E K , BIBLE K C , et al . 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer [J ] . Thyroid , 2016 , 26 ( 1 ): 1 - 133 . DOI: 10.1089/thy.2015.0020 http://doi.org/10.1089/thy.2015.0020

GOFFREDO P , ROBINSON T J , YOUNGWIRTH L M , et al . Intensity-modulated radiation therapy use for the localized treatment of thyroid cancer: nationwide practice patterns and outcomes [J ] . Endocrine , 2016 , 53 ( 3 ): 761 - 773 . DOI: 10.1007/s12020-016-0937-2 http://doi.org/10.1007/s12020-016-0937-2

RINGEL M D , SOSA J A , BALOCH Z , et al . 2025 American Thyroid Association management guidelines for adult patients with differentiated thyroid cancer [J ] . Thyroid , 2025 , 35 ( 8 ): 841 - 985 . DOI: 10.1177/10507256251363120 http://doi.org/10.1177/10507256251363120 https://www.liebertpub.com/doi/10.1177/10507256251363120 https://www.liebertpub.com/doi/10.1177/10507256251363120

RYU H , WU H G , LEE K E , et al . Effect of postoperative radiotherapy for patients with differentiated thyroid cancer [J ] . Clin Endocrinol , 2023 , 98 ( 6 ): 803 - 812 . DOI: 10.1111/cen.v98.6 http://doi.org/10.1111/cen.v98.6 https://onlinelibrary.wiley.com/toc/13652265/98/6 https://onlinelibrary.wiley.com/toc/13652265/98/6

LEE E K , LEE Y J , JUNG Y S , et al . Postoperative simultaneous integrated boost-intensity modulated radiation therapy for patients with locoregionally advanced papillary thyroid carcinoma: preliminary results of a phase Ⅱ trial and propensity score analysis [J ] . J Clin Endocrinol Metab , 2015 , 100 ( 3 ): 1009 - 1017 . DOI: 10.1210/jc.2014-3242 http://doi.org/10.1210/jc.2014-3242 https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2014-3242 https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2014-3242

MEGWALU U C , ORLOFF L A , MA Y F . Adjuvant external beam radiotherapy for locally invasive papillary thyroid cancer [J ] . Head Neck , 2019 , 41 ( 6 ): 1719 - 1724 . DOI: 10.1002/hed.v41.6 http://doi.org/10.1002/hed.v41.6 https://onlinelibrary.wiley.com/toc/10970347/41/6 https://onlinelibrary.wiley.com/toc/10970347/41/6

JACOMINA L E , JACINTO J K M , CO L B A , et al . The role of postoperative external beam radiotherapy for differentiated thyroid carcinoma: a systematic review and meta-analysis [J ] . Head Neck , 2020 , 42 ( 8 ): 2181 - 2193 . DOI: 10.1002/hed.v42.8 http://doi.org/10.1002/hed.v42.8 https://onlinelibrary.wiley.com/toc/10970347/42/8 https://onlinelibrary.wiley.com/toc/10970347/42/8

TAM S , AMIT M , BOONSRIPITAYANON M , et al . Adjuvant external beam radiotherapy in locally advanced differentiated thyroid cancer [J ] . JAMA Otolaryngol Head Neck Surg , 2017 , 143 ( 12 ): 1244 - 1251 . DOI: 10.1001/jamaoto.2017.2077 http://doi.org/10.1001/jamaoto.2017.2077 http://archotol.jamanetwork.com/article.aspx?doi=10.1001/jamaoto.2017.2077 http://archotol.jamanetwork.com/article.aspx?doi=10.1001/jamaoto.2017.2077

ADILBAY D , YUAN A , ROMESSER P B , et al . Well-differentiated thyroid cancer: who should get postoperative radiation ?[J ] . Ann Surg Oncol , 2022 , 29 ( 9 ): 5582 - 5590 . DOI: 10.1245/s10434-022-11898-2 http://doi.org/10.1245/s10434-022-11898-2

ROMESSER P B , SHERMAN E J , SHAHA A R , et al . External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer [J ] . J Surg Oncol , 2014 , 110 ( 4 ): 375 - 382 . DOI: 10.1002/jso.23656 http://doi.org/10.1002/jso.23656

MAKITA K , HAMAMOTO Y , TSURUOKA S , et al . Treatment intensity and control rates in combining external-beam radiotherapy and radioactive iodine therapy for metastatic or recurrent differentiated thyroid cancer [J ] . Int J Clin Oncol , 2020 , 25 ( 4 ): 691 - 697 . DOI: 10.1007/s10147-019-01591-y http://doi.org/10.1007/s10147-019-01591-y

ROMESSER P B , SHERMAN E J , WHITING K , et al . Intensity-modulated radiation therapy and doxorubicin in thyroid cancer: a prospective phase 2 trial [J ] . Cancer , 2021 , 127 ( 22 ): 4161 - 4170 . DOI: 10.1002/cncr.33804 http://doi.org/10.1002/cncr.33804

PALMA D A , OLSON R , HARROW S , et al . Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: long-term results of the SABR-COMET phase Ⅱ randomized trial [J ] . J Clin Oncol , 2020 , 38 ( 25 ): 2830 - 2838 . DOI: 10.1200/JCO.20.00818 http://doi.org/10.1200/JCO.20.00818 https://ascopubs.org/doi/10.1200/JCO.20.00818 https://ascopubs.org/doi/10.1200/JCO.20.00818

SAMHOURI L , KRIZ J , ELSAYAD K , et al . The role of radiotherapy for patients with thyroid cancer in the modern era [J ] . Anticancer Res , 2020 , 40 ( 6 ): 3379 - 3386 . DOI: 10.21873/anticanres.14321 http://doi.org/10.21873/anticanres.14321

KOCHER M , SOFFIETTI R , ABACIOGLU U , et al . Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study [J ] . J Clin Oncol , 2011 , 29 ( 2 ): 134 - 141 . DOI: 10.1200/JCO.2010.30.1655 http://doi.org/10.1200/JCO.2010.30.1655

PRINZI A , VAN VELSEN E F S , BELFIORE A , et al . Brain metastases in differentiated thyroid cancer: clinical presentation, diagnosis, and management [J ] . Thyroid , 2024 , 34 ( 10 ): 1194 - 1204 . DOI: 10.1089/thy.2024.0240 http://doi.org/10.1089/thy.2024.0240 https://www.liebertpub.com/doi/10.1089/thy.2024.0240 https://www.liebertpub.com/doi/10.1089/thy.2024.0240

MORENO A C , FRANK S J , GARDEN A S , et al . Intensity modulated proton therapy (IMPT). The future of IMRT for head and neck cancer [J ] . Oral Oncol , 2019 , 88 : 66 - 74 . DOI: 10.1016/j.oraloncology.2018.11.015 http://doi.org/10.1016/j.oraloncology.2018.11.015 https://linkinghub.elsevier.com/retrieve/pii/S136883751830424X https://linkinghub.elsevier.com/retrieve/pii/S136883751830424X

CICCONE L P , FRANZETTI J , BONORA M , et al . Charged particle radiotherapy for thyroid cancer. A systematic review [J ] . Crit Rev Oncol Hematol , 2024 , 202 : 104463 . DOI: 10.1016/j.critrevonc.2024.104463 http://doi.org/10.1016/j.critrevonc.2024.104463 https://linkinghub.elsevier.com/retrieve/pii/S1040842824002063 https://linkinghub.elsevier.com/retrieve/pii/S1040842824002063

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