Papel del yodo radiactivo en pacientes con cáncer diferenciado de tiroides como parte del tratamiento primario después de la tiroidectomía
DOI:
https://doi.org/10.18041/2390-0512/biociencias.2.10693Palabras clave:
Cáncer de tiroides, tiroidectomía, endocrinología, nódulo tiroideoResumen
Antecedentes: El cáncer de tiroides (CT) es la neoplasia endocrina más frecuente en el mundo, con una incidencia creciente. Según cifras de la Organización Mundial de la Salud, es la décimo octavo patología cancerosa más común en hombres y mujeres. Este aumento que se presenta en gran parte del mundo se está produciendo notablemente a expensas de la TC de tipo papilar, que representa el 85% de la TC, pero también se ha notado un aumento de tipo folicular.
Objetivo: Discutir el uso de yodo radiactivo para el tratamiento de cáncer de tiroides después de la tiroidectomía inicial dependiendo del riesgo de recurrencia o enfermedad persistente.
Metodología: Con el propósito de profundizar en el conocimiento relacionado con el cáncer diferenciado de tiroides y en la terapia con yodo como uno de los estandartes principales de su manejo se realizó una búsqueda exhaustiva y sistemática de la literatura publicada recientemente sobre todo en las últimas 2 décadas tanto nacional como extranjera. Se consultaron bases de datos de Elsevier y Medline mediante portales de búsqueda como Clinicalkey y Ovid, utilizando los términos de búsqueda Thyroid cáncer, thyroidectomy, endocrinology, Thyroid nodule y sus equivalentes en idioma español. La unidad de análisis de la presente revisión lo constituyó el cáncer diferenciado de tiroides y su manejo postquirúrgico con yodoterapia según su estratificación.
Resultados: Existen en la literatura numerosas evidencias científicas sobre la influencia de la terapia con yodo postquirúrgico en el pronóstico de pacientes con esta patología, lo cual va a depender de la estratificación del riesgo de recidiva.
Conclusión: No se recomienda yodoterapia para pacientes con CDT de bajo riesgo ATA; los pacientes de riesgo intermedio y características agresivas del tumor presentan beneficios en la supervivencia global. Por otro lado, se recomienda de rutina la yodoterapia para pacientes de alto riesgo.
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