甲状腺未分化癌诊疗指南总结与靶向治疗研究ppt课件
38页1、甲状腺未分化癌诊疗现状及进展,陕西省人民医院放疗科 陈鑫 博士 主治医师,American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer 2012,ATAG 2012 指南,ATAG 2012 指南,ATAG 2012 指南,ATAG 2012 指南,辅助及增敏化疗方案,ATAG 2012 指南,进展期化疗方案,ATAG 2012 指南,转移情况的文献汇总,2017 NCCN 指南 V2,术前完整评估分期情况后MDT讨论诊疗方案,2017 NCCN 指南 V2,AJCC 分期标准,2017 NCCN 指南推荐化疗方案,文献总结的治疗流程,Critical Reviews in Oncology/Hematology 86 (2013) 290301,与NCCN指南相同,放疗范围,瘤床区及高危区域高剂量,淋巴结区域低剂量 指南推荐IMRT放疗,Critical Reviews in Oncology/Hematology 86 (2013) 290301,术
2、后治疗方案的研究情况,Critical Reviews in Oncology/Hematology 86 (2013) 290301,Critical Reviews in Oncology/Hematology 86 (2013) 290301,转归研究情况,Critical Reviews in Oncology/Hematology 86 (2013) 290301,转归研究情况,Critical Reviews in Oncology/Hematology 86 (2013) 290301,分化混杂ATC的研究报道结果,Clinical ReviewAnaplastic Thyroid Carcinoma:Treatment in the Age of Molecular Targeted Therapy,The University of Texas MD Anderson Cancer Center, Houston, TX,Journal of Oncology Practice12, no.6 (June 2016) 511-518.,甲状腺未分化癌最常见的十种基因突
3、变,Journal of Oncology Practice12, no.6 (June 2016) 511-518.,Curative intent treatment is multimodal and consists of surgery (R0 or R1 resection) and external beam radiationtherapy with radiosensitizing chemotherapy,此案例也未切除对策甲状腺,Journal of Oncology Practice12, no.6 (June 2016) 511-518.,Common chemotherapy regi-mens used for radiosensitization in anaplastic thyroid carcinoma,Journal of Oncology Practice12, no.6 (June 2016) 511-518.,NOVEL THERAPIES,Molecular targeted therapy trials in anaplastic th
4、yroid carcinoma have been conducted under the basket protocol design and have been largely directed at targetting BRAF mutations. Other mutation specifictrials,suchas those that target PIK3CA, HRAS, and ALK, are also available for patients with anaplastic thyroid carcinoma,but these mutations are even rarer than BRAF mutations in anaplastic thyroid carcinoma (13%, 4%, and1.5%,respectively).,Journal of Oncology Practice12, no.6 (June 2016) 511-518.,BRAF-Directed Therapies,Two basket trials have c
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