Effective treatment of teenage pregnancy: A Synthesis of Findings from 23 Studies

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Original Abstract of the Article

Major Research Findings

The research on thyroid cancer treatment has been making progress in recent years. While most cases of differentiated thyroid cancer (DTC) are curable with surgery and radioactive iodine (RAI), there are still challenges when DTC becomes RAI-refractory (RAI-R). 5 New targeted therapies are being explored for these patients, including clinical trials with novel agents. 5

The extent of surgery for low-risk papillary thyroid cancer (PTC) is still a subject of debate. While the 2015 American Thyroid Association (ATA) guidelines recommend thyroid lobectomy (TL) as an acceptable alternative to total thyroidectomy (TT), the optimal approach remains controversial. 13 The decision is often difficult as the effectiveness of RAI treatment is uncertain, lacking long-term randomized controlled trials. 3

Moreover, the role of radioiodine (131I) for treating DTC is being questioned, and a growing number of patients are opting for lobectomy or total thyroidectomy without 131I. 16 This shift in treatment approach requires a revised management and follow-up plan for these patients.

Treatment Summary

The treatment approach for thyroid cancer varies depending on the type of cancer, its stage, and the patient's age and overall health.

For low-risk papillary thyroid cancer, thyroid lobectomy is being considered as an alternative to total thyroidectomy. 13

Radioactive iodine is often used after surgery to destroy any remaining thyroid tissue. 2

For patients with RAI-refractory DTC, new targeted therapies are being developed. 5 These therapies, often referred to as kinase inhibitors, aim to slow down tumor growth. 4

Benefits and Risks

Benefit Summary

Treatment for thyroid cancer aims to control the cancer's progression and improve survival rates.

Thyroid lobectomy offers lower risks of complications compared to total thyroidectomy for low-risk papillary thyroid cancer. 13

Radioactive iodine treatment can help reduce the risk of thyroid cancer recurrence. 2

Targeted therapies are proving effective in treating RAI-refractory DTC. 5

Risk Summary

Treatment for thyroid cancer comes with potential side effects.

Surgery can lead to complications such as bleeding and infections.

Radioactive iodine treatment can cause side effects like hypothyroidism and low white blood cell count.

Targeted therapies can cause side effects like hypertension, hand-foot syndrome, and diarrhea. 4

Comparison Across Studies

Commonalities

Multiple studies emphasize the importance of choosing the most appropriate treatment based on the type of cancer, its stage, and the patient's age and overall health.

Differences

There are variations across studies regarding the effectiveness of treatment options and the occurrence of side effects. These discrepancies could be due to differences in the characteristics of patients studied and the research methodologies used.

Consistency and Contradictions in Findings

Research findings on thyroid cancer treatment are consistent in some areas but contradictory in others.

For instance, the research is inconclusive regarding the effectiveness of thyroid lobectomy vs total thyroidectomy for low-risk papillary thyroid cancer.

Application in Everyday Life: Points to Consider

It's crucial to remember that research findings on thyroid cancer treatment cannot be directly applied to your personal case.

When making decisions about your treatment plan, it is essential to consult your doctor and discuss the best course of action for your specific situation.

Limitations of Current Research

There are limitations to the current research on thyroid cancer treatment:

- The number of patients included in some studies is small.

- The duration of some studies is limited.

- Research methodologies can be biased.

Future Directions for Research

Future research on thyroid cancer treatment should address the following:

- Include a larger number of participants in studies.

- Conduct longer-term research.

- Utilize various and unbiased research methodologies.

Conclusion

Treatment for thyroid cancer requires a personalized approach based on the cancer type, stage, and patient characteristics.

Always consult your doctor to discuss the most appropriate treatment for your specific situation.

Treatment List

Surgery, radioactive iodine therapy, hormone replacement therapy, targeted therapy

Literature analysis of 23 papers
Positive Content
22
Neutral Content
1
Negative Content
0
Article Type
4
6
19
9
21
1.

Pharmacotherapy for thyroid nodules. A systematic review and meta-analysis.

Author: RichterBernd, NeisesGudrun, ClarChristine

Nodular thyroid disease treatment
Atrial fibrillation
Hyperthyroidism
Reduced bone density

The study highlights the uncertainty surrounding the use of thyroxine suppressive treatment for nodular thyroid disease, emphasizing the need for more high-quality research.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Clinical review 170: A systematic review and metaanalysis of the effectiveness of radioactive iodine remnant ablation for well-differentiated thyroid cancer.

Author: SawkaAnna M, ThephamongkholKullathorn, BrouwersMelissa, ThabaneLehana, BrowmanGeorge, GersteinHertzel C

Distant metastases
Locoregional recurrence
Thyroid cancer recurrence

Radioactive iodine remnant ablation may reduce the risk of thyroid cancer recurrence after surgery, especially for locoregional recurrence and distant metastases, but the benefit for low-risk patients is unclear.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Decision aid on radioactive iodine treatment for early stage papillary thyroid cancer--a randomized controlled trial.

Author: SawkaAnna M, StrausSharon, BrierleyJames D, TsangRichard W, RotsteinLorne, RodinGary, GafniAmiram, EzzatShereen, ThabaneLehana, ThorpeKevin E, GoldsteinDavid P

Treatment for PTC

This article discusses the conflicting reports of benefit and the lack of long-term randomized controlled trials for adjuvant radioactive iodine (RAI) treatment after thyroidectomy in patients with early stage papillary thyroid carcinoma (PTC).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Pharmacotherapy options for advanced thyroid cancer: a systematic review.

Author: LerchChristian, RichterBernd

Improved survival
Increased risk of second cancers

This review of studies investigating drug treatment for advanced thyroid cancer found that while new drugs, especially kinase inhibitors, show promise, their effectiveness remains unclear due to the lack of adequate randomized controlled trials. The studies reviewed reported a median progression-free survival of around 12 months, with adverse events such as hypertension, hand-foot syndrome, and diarrhea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Clinical, safety, and economic evidence in radioactive iodine-refractory differentiated thyroid cancer: a systematic literature review.

Author: AndersonRoger T, LinnehanJohn E, TongbramVanita, KeatingKaren, WirthLori J

Thyroid cancer treatment

This study examines potential treatments for differentiated thyroid cancer (DTC) that has become resistant to radioactive iodine (RAI), a common treatment for this type of cancer. The review focuses on clinical trials of novel targeted therapies and evaluates their effectiveness, safety, and cost.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Genetic mutations in the treatment of anaplastic thyroid cancer: a systematic review.

Author: GuerraAnna, Di CrescenzoVincenzo, GarziAlfredo, CinelliMariapia, CarlomagnoChiara, TonaccheraMassimo, ZeppaPio, VitaleMario

Improved survival

Anaplastic thyroid cancer (ATC) is a rare and aggressive disease with a median survival of only 6 months despite multidisciplinary care. Surgery is often palliative, and multidisciplinary care includes surgery, loco-regional radiotherapy, and systemic therapy. Emerging kinase-targeted inhibitors show promise as novel therapeutic tools, targeting the numerous molecular alterations found in ATC.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Effects of short-term metformin therapy associated with levothyroxine dose decrement on TSH and thyroid hormone levels in patients with thyroid cancer.

Author: MousaviZ, DourandishL, RokniH, SadeghiR, Rasoul ZakaviS

Subclinical hyperthyroidism

A single-blind randomized controlled trial of 50 non-diabetic patients with DTC found that adding 500 mg of metformin to the drug regimen was not useful to compensate for a 33% reduction in levothyroxine dose.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

New therapeutic options for advanced forms of thyroid cancer.

Author: BernetVictor, SmallridgeRobert

Thyroid cancer treatment

While most people with thyroid cancer have a good prognosis, some experience aggressive forms of the disease that can be difficult to treat. New medications are being investigated for treating advanced thyroid cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Total or near-total thyroidectomy versus subtotal thyroidectomy for multinodular non-toxic goitre in adults.

Author: CirocchiRoberto, TrastulliStefano, RandolphJustus, GuarinoSalvatore, Di RoccoGiorgio, ArezzoAlberto, D'AndreaVito, SantoroAlberto, BarczyñskiMarcin, AveniaNicola

Safer option
Similar effectiveness
Undetected thyroid cancer

Total thyroidectomy (TT) and subtotal thyroidectomy (ST) are treatment options for multinodular non-toxic goitre. This study compares the effectiveness and safety of near-total thyroidectomy (near TT) to TT and ST.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Lenvatinib for the treatment of radioiodine-refractory differentiated thyroid carcinoma: a systematic review and indirect comparison with sorafenib.

Author: KawalecPawel, Malinowska-LipieńIwona, BrzostekTomasz, KózkaMaria

Improved survival
Sorafenib and lenvatinib efficacy
Thyroid cancer treatment
Orphan drug status

This systematic review compared the efficacy and safety of lenvatinib and sorafenib, two tyrosine kinase inhibitors (TKIs), for the treatment of advanced radioactive iodine-refractory differentiated thyroid cancer (RR-DTC).

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Differentiated Thyroid Cancer-Treatment: State of the Art.

Author: SchmidbauerBenedikt, MenhartKarin, HellwigDirk, GrosseJirka

DTC treatment

Differentiated thyroid cancer (DTC) is a rare type of cancer that usually has a good outcome. Treatment typically involves surgery, radioactive iodine, and thyroid hormone replacement. While most cases are cured with these methods, new treatments are being developed for rare cases that don't respond to radioactive iodine. These newer medications can slow down tumor growth but may have serious side effects and are only used for patients with severe symptoms.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Cabozantinib and vandetanib for unresectable locally advanced or metastatic medullary thyroid cancer: a systematic review and economic model.

Author: TappendenPaul, CarrollChristopher, HamiltonJean, KaltenthalerEva, WongRuth, WadsleyJonathan, MossLaura, BalasubramanianSabapathy

Cabozantinib
Medullary thyroid cancer treatment
Vandetanib

Medullary thyroid cancer (MTC) is a rare cancer that can significantly impact patients' quality of life and survival. Cabozantinib and vandetanib are currently the most commonly used treatments for advanced MTC.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Lobectomy Compared to Total Thyroidectomy for Low-Risk Papillary Thyroid Cancer: A Systematic Review.

Author: Vargas-PintoSusana, Romero ArenasMinerva A

Improved PTC treatment

This study addressed the controversy surrounding the optimal extent of surgery for small and less aggressive papillary thyroid cancers (PTC), considering the 2015 American Thyroid Association (ATA) guidelines recommending thyroid lobectomy (TL) in certain cases.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

A systematic review of lenvatinib and sorafenib for treating progressive, locally advanced or metastatic, differentiated thyroid cancer after treatment with radioactive iodine.

Author: FleemanNigel, HoutenRachel, ChaplinMarty, BealeSophie, BolandAngela, DundarYenal, GreenhalghJanette, DuarteRui, ShenoyAditya

Improved RR-DTC treatment

Radioactive iodine is an effective treatment for many patients with thyroid cancer, but some become refractory to treatment. This study focuses on radioactive iodine refractory differentiated thyroid cancer (RR-DTC).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Lenvatinib and sorafenib for differentiated thyroid cancer after radioactive iodine: a systematic review and economic evaluation.

Author: FleemanNigel, HoutenRachel, BagustAdrian, RichardsonMarty, BealeSophie, BolandAngela, DundarYenal, GreenhalghJanette, HounsomeJuliet, DuarteRui, ShenoyAditya

DTC treatment

Thyroid cancer is a rare cancer, and differentiated thyroid cancer (DTC) is the most common type. Radioactive iodine is often used to treat DTC. For people who don't respond to radioactive iodine, treatment options are limited, and supportive care is often the only approach.

Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Management and follow-up of differentiated thyroid cancer not submitted to radioiodine treatment: a systematic review.

Author: GambaleCarla, EliseiRossella, MatroneAntonio

Improved DTC treatment

This study discussed the evolving treatment landscape for differentiated thyroid cancer (DTC), considering the increasing use of conservative surgery and the potential for alternative approaches to radioiodine (<sup>131</sup>I) therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

Current surgical treatment of intermediate risk differentiated thyroid cancer: a systematic review.

Author: GuoMichael Y, WisemanJacob J, WisemanSam M

Adjuvant radioactive iodine
Avoidance of thyroid hormone
Comparable survival outcomes
Cost-effective TL
Lower complication risk
Lower recurrence risk
Simpler follow-up
Poorer outcomes for larger cancers
Risk of CT
Unclear threshold for TT

This review examines the extent of surgery (total thyroidectomy vs. thyroid lobectomy) for treating intermediate-risk differentiated thyroid cancer, considering the latest American Thyroid Association (ATA) guidelines and the potential benefits and risks of each approach.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

18.

Which is preferred for initial treatment of papillary thyroid cancer, total thyroidectomy or lobotomy?

Author: WuZhen, HanLin, LiWenlei, WangWei, ChenLiqaing, YaoYumin, WangYongkun

Thyroid cancer treatment

This study investigates the effectiveness of lobectomy versus total thyroidectomy as the initial surgical mode for thyroid cancer, based on data from patients treated in Liaocheng People's Hospital from 2015 to 2018.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Adjuvant radiotherapy and radioiodine treatment for locally advanced differentiated thyroid cancer: systematic review and meta-analysis.

Author: DicuonzoSamantha, PedrettiSara, MangoniMonica, MonariFabio, FanettiGiuseppe, BorsattiEugenio, LombardiDavide, VianelloFederica, IacoboneMaurizio, CorvòRenzo, MagriniStefano M, PappagalloGiovanni, ArcangeliStefano, D'AngelilloRolando M

EBRT efficacy
Locoregional control
Toxicity

The addition of external beam radiotherapy (EBRT) to radioiodine after surgery for locally advanced differentiated thyroid cancer may improve locoregional control. However, the benefit/harms balance is uncertain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

20.

Apatinib vs Placebo in Patients With Locally Advanced or Metastatic, Radioactive Iodine-Refractory Differentiated Thyroid Cancer: The REALITY Randomized Clinical Trial.

Author: LinYansong, QinShukui, LiZhiyong, YangHui, FuWei, LiShaohua, ChenWenxin, GaoZairong, MiaoWeibing, XuHuiqin, ZhangQing, ZhaoXinming, BaoJiandong, LiLinfa, RenYuan, LinChenghe, JingShanghua, MaQingjie, LiangJun, ChenGuang, ZhangHong, ZhangYifan, ZhouXianfeng, SangYaxiong, HouZhiguo

Improved overall survival
Prolonged PFS
Hand-foot syndrome
Hypertension
Proteinuria

Apatinib, a VEGFR-2 inhibitor, showed significant clinical benefits in patients with progressive locally advanced or metastatic radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) in a phase 3 trial. The drug demonstrated prolonged progression-free survival (PFS) and overall survival with a manageable safety profile.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Complication Rates of Total Thyroidectomy vs Hemithyroidectomy for Treatment of Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-analysis.

Author: HsiaoVivian, LightTyler J, AdilAbdullah A, TaoMichael, ChiuAlexander S, HitchcockMary, ArroyoNatalia, Fernandes-TaylorSara, FrancisDavid O

Low-risk cancers

Total thyroidectomy (TT) has been the primary treatment for papillary thyroid microcarcinomas (PTMCs), but current guidelines recommend hemithyroidectomy (HT) for select low-risk cancers. This study aims to further clarify the risk-benefit ratio of these two surgical approaches.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

22.

Safety and efficacy of ultrasound-guided thermal ablation in treating T1aN0M0 and T1bN0M0 papillary thyroid carcinoma: A meta-analysis.

Author: WangMei-Huan, LiuXiao, WangQian, ZhangHua-Wei

PTC treatment

Papillary thyroid cancer (PTC) is the most common type of thyroid tumor. Early diagnosis and treatment are crucial for improving prognosis. Thermal ablation (TA) has shown potential benefits in the treatment of PTC patients, but its safety and efficacy remain controversial. This meta-analysis evaluates the efficacy and safety of TA in patients with T1aN0M0 and T1bN0M0 PTC.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

[Hemithyroidectomy or total thyroidectomy for low-risk papillary thyroid cancer? : Surgical criteria for primary and secondary choice of treatment in an interdisciplinary treatment concept].

Author: DralleH, WeberF, MachensA, BrandenburgT, SchmidK W, Führer-SakelD

Oncological outcomes
Postoperative complications

This systematic review of 20 clinical studies found that hemithyroidectomy (HT) resulted in comparable long-term oncological outcomes to total thyroidectomy (TT) for low-risk papillary thyroid cancer (LRPTC) 1-4 cm in diameter, while postoperative complication rates were significantly lower for HT.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

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