甲状腺癌是最常见的内分泌系统恶性肿瘤，按组织病理类型可以分为乳头状甲状腺癌、滤泡状甲状腺癌、髓样甲状腺癌和未分化型甲状腺癌。前两者因分化水平较高统称为分化型甲状腺癌。分化型甲状腺癌首选手术治疗，其次针对术中未能切除的残余病灶进行放射碘治疗。外照射放疗在分化型甲状腺癌及甲状腺髓样癌中的作用仅局限于手术治疗失败、肿瘤不能切除或者有肉眼可见远处转移灶残留的患者。精确放疗可增加肿瘤的局部控制率，减少正常组织的放射损伤。而甲状腺未分化癌大多数不能完全手术切除，外照射放疗联合化疗具有重要作用。放疗作为术前、术后综合治疗的一部分发挥作用，也可以采用单纯放疗的形式缓解症状、控制病变生长，从而延长生存期，起到姑息治疗的目的。%Thyroid carcinoma is the most common malignant tumor of the endocrine system, which can be divided into four kinds according to the pathological type: papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and undifferentiated thyroid cancer. The first two are known together as differentiated thyroid cancer due to the high level of differentiation. The initial management of differentiated thyroid cancer is surgery, followed by radioactive iodine for gross residual or unresectable dis-ease. For both differentiated thyroid cancer and medullary thyroid cancer, the role of external beam radiotherapy after resection of gross disease when there is a high risk of local regional failure is reviewed. Accurate radiotherapy can reduce the risk of the local recurrence and the radiation injury to normal tissue. In anaplastic thyroid cancer, although most patients present with unresectable disease and ra-diotherapy is the mainstay of treatment, the benefits of the addition of chemotherapy to radiation therapy will be discussed. External beam radiotherapy not only plays a role as a part of combined treatment of preoperative and postoperative, but also can be used sepa-rately to alleviate symptoms, control the growth of the lesion and prolong the overall survival to serve the purpose of palliative treatment.
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