Thyroid cancer – treatment options

master's thesis

• Title (croatian): Liječenje bolesnika s karcinomom štitnjače
• Author: Roman Ritter
• Mentor: Dražen Huić (mentor)
• Committee member: Dražen Huić (predsjednik povjerenstva)
• Committee member: Sanja Kusačić Kuna (član povjerenstva)
• Committee member: Jasmina Marić Brozić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Nuclear Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Nuclear Medicine

Abstract

Thyroid cancer is rapidly increasing in incidence, yet the mortality rate remains relatively constant. Given its’ favorable prognosis and great success in treatment of the most common types, it is currently debated, whether the incidence rise should change the way the screening is performed and affect the established treatment guidelines. In this literature review four of the most prominent thyroid gland cancers and their management options are presented; papillary, follicular, medullary and anaplastic carcinomas. The appropriate approach to surgical management for thyroid cancer is discussed, as some researchers advocate partial and others total thyroidectomy. There are advocates of prophylactic central cervical lymph node dissection through radical procedures, whereas other experts recommend lymphadenectomy in only specific cases. Radioactive iodine application in both treatment (ablation) and diagnosis (scanning) are also debated in terms of their specificity, sensitivity, dosage and conjunction with other methods. Chemotherapy is currently actively researched, as the traditional cytotoxic drugs are giving way to newer targeted agents, that promise to both decrease the rates of adverse effects and assist in treatment of poorly differentiated aggressive cancers. For palliation of terminally ill patients and management of distant metastases with unfavorable prognoses external beam radiation is traditionally used and continues to serve as a back-up therapy in cases of iodine-negative tumours. Additionally, follow-up strategies are briefly presented to give an overview of up-to-date research data, that reflects the extent of management success and the improvement in the quality of life.

Abstract (croatian)

Učestalost karcinoma štitnjače brzo raste, ali stopa mortaliteta ostaje relativno konstantna. S obzirom na njegovu povoljnu prognozu i veliki uspjeh u liječenju najčešćih vrsta, trenutno se raspravlja o tome bi li porast učestalosti trebao promijeniti način provođenja probira i utjecati na utvrđene smjernice liječenja. U ovom radu, predstavljena su četiri najznačajnija karcinoma štitnjače i njihove mogućnosti liječenja; papilarni, folikularni, medularni i anaplastični karcinomi. Raspravlja se o prikladnom pristupu kirurškom liječenju karcinoma štitnjače, jer neki istraživači zagovaraju djelomičnu, a drugi totalnu tireoidektomiju. Postoje zagovornici profilaktičke disekcije centralnih cervikalnih limfnih čvorova koristeći se radikalnim postupcima, dok drugi stručnjaci preporučuju limfadenektomiju samo u određenim slučajevima. O primjeni radioaktivnog joda u liječenju (ablacija) i dijagnozi (skeniranja) također se raspravlja u pogledu njegove specifičnosti, osjetljivosti, doziranja i povezanosti s drugim metodama. Kemoterapija se trenutno aktivno istražuje, dok tradicionalni citotoksični lijekovi ustupaju mjesto novijom ciljanom terapijom, koja obećava smanjenje stope štetnih učinaka kao i pomoć prilikom liječenja slabo diferenciranih agresivnih karcinoma. Za palijativnu skrb neizlječivih bolesnika i liječenje udaljenih metastaza s nepovoljnim prognozama, tradicionalno se koristi vanjsko zračenje i nastavlja služiti kao rezervna terapija u slučaju tumora koji su jod negativni. Također, ukratko su predstavljene strategije praćenja pacijenata radi boljeg pregleda najnovijih podataka istraživanja, koji odražavaju opseg uspjeha terapije kao i poboljšanje kvalitete života.

• Keywords: thyroid cancer; thyroidectomy; radioactive iodine ablation; chemotherapy; external beam radiation
• Keywords (croatian): karcinom štitnjače; tireoidektomija; radioaktivna jodna ablacija; kemoterapija; vanjsko zračenje
• Language: english
• URN:NBN: urn:nbn:hr:105:773148
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-12-21 12:52:01