Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press310.17650/2222-1468-2013-0-2-5-8DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ ГОЛОВЫ И ШЕИCONTEMPORARY APPROACHES TO LEVOTHYROXINE THERAPY AFTER SURGERY IN PATIENTS WITH WELL-DIFFERENTIATED THYROID CANCERСОВРЕМЕННЫЕ ПРИНЦИПЫ ТЕРАПИИ ЛЕВОТИРОКСИНОМ ПОСЛЕ ОПЕРАЦИИ У БОЛЬНЫХ ВЫСОКОДИФФЕРЕНЦИРОВАННЫМ РАКОМ ЩИТОВИДНОЙ ЖЕЛЕЗЫRumyantsevP. O.РумянцевП. О.
Russian Federation
rumyantsev.pavel@endocrincentr.ruKorenevS. V.КореневС. В.
Russian Federation
RumyantsevaU. V.РумянцеваУ. В.
Russian Federation
Endocrinology Research Center, MoscowФГБУ «Эндокринологический научный центр» Минздрава России, МоскваMedical institute, Immanuel Kant Baltic Federal University, KaliningradМедицинский институт ФГАОУ ВПО «Балтийский федеральный университет им. Иммануила Канта», Калининград1504201332581504201515042015Copyright ©; 2013, Rumyantsev P.O., Korenev S.V., Rumyantseva U.V.Copyright ©; 2013, Румянцев П.О., Коренев С.В., Румянцева У.В.2013Rumyantsev P.O., Korenev S.V., Rumyantseva U.V.Румянцев П.О., Коренев С.В., Румянцева У.В.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/3

Levothyroxine therapy with purpose to suppress thyroid stimulating hormone (TSH) after surgery in patients with well-differentiated thyroid cancer is implemented since 1937. Accumulated results of levothyroxine suppressive therapy (LST) application are attesting its heterogeneous efficacy in various risk groups of tumor recurrence: low, medium and high. Similar risk groups are emphasized towards adverse effect risk due to LST. The more intensivity and duration of TSH suppression the higher risk of adverse effects. First, they include osteopenia or osteoporosis and atrial fibrillation. Contemporary approaches to intensivity and duration of LTS are based on accounting of its potential efficiency into various clinical risk groups of tumor recurrence as well as adverse effects risk groups.

Терапия левотироксином с целью супрессии тиреотропного гормона (ТТГ) в послеоперационном периоде у больных высокодиффе- ренцированным раком щитовидной железы (ЩЖ) применяется более 70 лет. Накопленные результаты использования супрессивной терапии левотироксином (СТЛ) свидетельствуют о неоднородности ее эффективности в различных клинических группах: высокого, умеренного и низкого риска рецидива опухоли. Выделяют также клинические группы риска по развитию осложнений СТЛ. Чем интенсивнее и длительнее режим супрессии ТТГ, тем выше риск развития нежелательных эффектов СТЛ. К ним в первую очередь относят снижение костной плотности и мерцательную аритмию предсердий. Современные подходы к интенсивности и длительной СТЛ базируются на учете ее потенциальной эффективности в различных группах клинического риска рецидива высокодифференцированного рака ЩЖ с одной стороны и группах риска по развитию нежелательных эффектов с другой стороны.

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