Bone metastases from differentiated thyroid carcinoma: current knowledge and open issues

被引:34
作者
Nervo, A. [1 ]
Ragni, A. [1 ]
Retta, F. [1 ]
Gallo, M. [1 ]
Piovesan, A. [1 ]
Liberini, V [2 ]
Gatti, M. [3 ]
Ricardi, U. [4 ]
Deandreis, D. [2 ]
Arvat, E. [1 ]
机构
[1] Univ Turin, Citta Salute & Sci Hosp, Dept Med Sci, Oncol Endocrinol Unit, Turin, Italy
[2] Univ Turin, Citta Salute & Sci Hosp, Dept Med Sci, Nucl Med, Turin, Italy
[3] Univ Turin, Citta Salute & Sci Hosp, Dept Surg Sci, Radiol Unit, Turin, Italy
[4] Univ Turin, Citta Salute & Sci Hosp, Dept Oncol, Radiat Oncol, Turin, Italy
关键词
Thyroid cancer; Skeletal-related event; Metastatic disease; Cancer management; EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY; RADIOACTIVE IODINE TREATMENT; ZOLEDRONIC ACID; SPINAL METASTASES; CANCER-PATIENTS; PERCUTANEOUS VERTEBROPLASTY; ASSOCIATION GUIDELINES; SKELETAL COMPLICATIONS; RADIOIODINE TREATMENT; PROGNOSTIC-FACTORS;
D O I
10.1007/s40618-020-01374-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Bone represents the second most common site of distant metastases in differentiated thyroid cancer (DTC). The clinical course of DTC patients with bone metastases (BM) is quite heterogeneous, but generally associated with low survival rates. Skeletal-related events might be a serious complication of BM, resulting in high morbidity and impaired quality of life. To achieve disease control and symptoms relief, multimodal treatment is generally required: radioiodine therapy, local procedures-including surgery, radiotherapy and percutaneous techniques-and systemic therapies, such as kinase inhibitors and antiresorptive drugs. The management of DTC with BM is challenging: a careful evaluation and a personalized approach are essential to improve patients' outcomes. To date, prospective studies focusing on the main clinical aspects of DTC with BM are scarce; available analyses mainly include cohorts assembled over multiple decades, small samples sizes and data about BM not always separated from those regarding other distant metastases. The aim of this review is to summarize the most recent evidences and the unsolved questions regarding BM in DTC, analyzing several key issues: pathophysiology, prognostic factors, role of anatomic and functional imaging, and clinical management.
引用
收藏
页码:403 / 419
页数:17
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