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Онкологический журнал: лучевая диагностика, лучевая терапия

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Радиойодаблация при раке щитовидной железы. Исторические и современные аспекты. Обзор литературы

https://doi.org/10.37174/2587-7593-2021-4-4-9-19

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Аннотация

Рак щитовидной железы является наиболее распространенной онкологической патологией среди органов эндокринной системы с сохраняющейся тенденцией к росту заболеваемости. Радиойодтерапия является вторым этапом комбинированного лечения, проводится только в качестве адъювантного лечения после тиреоидэктомии, является безальтернативным методом радиотаргетной терапии отдаленных метастазов дифференцированного рака щитовидной железы (ДРЩЖ). Метод радиойодтерапии основан на уникальном природном сродстве атомов йода к фолликулярному эпителию щитовидной железы и клеткам ДРЩЖ. Определение показаний к радиойодтерапии основывается на стратификации риска рецидива, персистенции и степени распространенности заболевания. В течение последних 15 лет ведущие мировые профессиональные сообщества неоднократно пересматривали подходы к стратификации риска. Значимыми нововведениями стали учет мутационного профиля опухоли и тераностический подход.
Радиойодтерапия может быть представлена в виде трех режимов: аблации остаточной тиреоидной ткани, лечения остаточной опухоли и лечения отдаленных метастазов. Эти режимы отличаются вводимой лечебной активностью 131I, что логично выглядит с точки зрения необходимой персонификации лечения. При этом в научных кругах не утихают споры об отсутствии значимых различий используемых лечебных активностях 131I, назначаемых для радиойодаблации вне персонифицированного подхода.

Об авторах

А. Ю. Шуринов
Медицинский радиологический научный центр им. А.Ф. Цыба — филиал ФГБУ НМИЦ радиологии Минздрава России
Россия

Шуринов Андрей Юрьевич  — н.с. отделения радиохирургического лечения открытыми радионуклидами 

249031, Калужская обл., Обнинск, ул. Королева, 4



В. В. Крылов
Медицинский радиологический научный центр им. А.Ф. Цыба — филиал ФГБУ НМИЦ радиологии Минздрава России
Россия

Крылов Валерий Васильевич — д.м.н., руководитель отделения радиохирургического лечения открытыми радионуклидами 

249031, Калужская обл., Обнинск, ул. Королева, 4



Е. В. Бородавина
Медицинский радиологический научный центр им. А.Ф. Цыба — филиал ФГБУ НМИЦ радиологии Минздрава России
Россия

Бородавина Екатерина Владимировна — н.с. отделения радиохирургического лечения открытыми радионуклидами 

249031, Калужская обл., Обнинск, ул. Королева, 4



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Рецензия

Для цитирования:


Шуринов А.Ю., Крылов В.В., Бородавина Е.В. Радиойодаблация при раке щитовидной железы. Исторические и современные аспекты. Обзор литературы. Онкологический журнал: лучевая диагностика, лучевая терапия. 2021;4(4):9-19. https://doi.org/10.37174/2587-7593-2021-4-4-9-19

For citation:


Shurinov A.Yu., Krylov V.V., Borodavina E.V. Radioiodine Ablation for Thyroid Cancer. Historical and Modern Aspects. Literature Review. Journal of oncology: diagnostic radiology and radiotherapy. 2021;4(4):9-19. (In Russ.) https://doi.org/10.37174/2587-7593-2021-4-4-9-19



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