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Abstract：
Background: Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Since the guidelines for the management of ATC by the American Thyroid Association were first published in 2012, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, and researchers on published evidence relating to the diagnosis and management of ATC. Methods: The specific clinical questions and topics addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of the Task Force members (authors of the guideline). Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. Results: The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, targeted/systemic therapy, supportive care during active therapy), approaches to advanced/metastatic disease, palliative care options, surveillance and long-term monitoring, and ethical issues, including end of life. The guidelines include 31 recommendations and 16 good practice statements. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of ATC. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with ATC.
摘要：
背景：间变性甲状腺癌（ATC）是一种罕见但高度致命的甲状腺癌。自2012年美国甲状腺协会首次发布ATC管理指南以来，该领域已取得了重大的临床和科学进展。这些指南的目的是告知临床医生，病人,和研究人员发表的有关ATC诊断和管理的证据。方法：这些指南中涉及的具体临床问题和主题基于以前版本的指南，利益相关者的投入，和工作队成员(指南的作者)的输入。回顾了相关文献，包括补充了其他文章的串行PubMed搜索。美国医师学会指南分级系统用于对证据进行严格评估和建议的分级强度。结果：指南包括诊断，初步评估，建立治疗目标，局部疾病的方法(手术，放射治疗,靶向/全身治疗，积极治疗期间的支持性护理)，晚期/转移性疾病的方法，姑息治疗方案,监测和长期监测，和道德问题，包括生命的终结。准则包括31项建议和16项良好做法声明。结论：我们已经制定了基于证据的建议，以告知ATC管理中的临床决策。虽然所有护理都必须个性化，这些建议提供，在我们看来,ATC患者的最佳护理模式。
