{"id":871,"date":"2020-09-21T14:52:58","date_gmt":"2020-09-21T14:52:58","guid":{"rendered":"http:\/\/tiro.flywheelsites.com\/clinical-trial-options\/"},"modified":"2022-02-04T15:08:21","modified_gmt":"2022-02-04T20:08:21","slug":"clinical-trial-options","status":"publish","type":"page","link":"https:\/\/tiro.expert\/es\/clinical-trial-options\/","title":{"rendered":"Opciones de ensayos cl\u00ednicos"},"content":{"rendered":"\t<style media=\"screen\">\n\t:root { --row-count: 4; }\n\t<\/style>\n<div class=\"clinical-outline-wrap open\">\n\t<div class=\"outline-header\">\n\t\t<p><strong>Clinical Trial Options<\/strong><\/p>\t\t<p>Clinical Outline<\/p>\n\t<\/div>\n\n\t<div id=\"toc\">\n\t\t<div class=\"aod-opener opened\"><\/div>\n\t\t<div class=\"toc-content\"><\/div>\n\t<\/div>\n\n\t<div id=\"edu\" class=\"wp-block-group__inner-container legend\">\n\t\t<div class=\"aod-opener\"><\/div>\n\n\t\t<div class=\"table-wrap aod-content\">\n\t\t\t<div class=\"table-grid\">\n\n\t\t\t\t<div class=\"table-header table-row\">\n\t\t\t\t\t<div class=\"fixed-col\">Educational Clips from TIROxMDS<\/div>\n\n\t\t\t\t\t<div><i class=\"fad fa-chalkboard-teacher fa-fw fa-lg\" title=\"Primers in Thyroidology\"><\/i><\/div>\n\t\t\t\t\t<div><i class=\"fad fa-presentation fa-fw fa-lg\" title=\"Journal Club Presentation\"><\/i><\/div>\n\t\t\t\t\t<div><i class=\"fad fa-comments fa-fw fa-lg\" title=\"Case-based Discussion (inc. roundtables)\"><\/i><\/div>\n\t\t\t\t\t<div><i class=\"fad fa-podium fa-fw fa-lg\" title=\"Grand Rounds Lectureship\"><\/i><\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"\">Reasons to Enter Patients into Clinical Trials<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check-plus-two\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check-plus-two\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check-plus-one\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t<div id=\"key\" class=\"legend\">\n\t\t\t\t<div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-chalkboard-teacher fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Primers in Thyroidology<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-presentation fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Journal Club Presentation<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-comments fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Case-based Discussion (inc. roundtables)<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-podium fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Grand Rounds Lectureship<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n\n\t<div class='outline-tab closer'><i class='fas fa-times'><\/i><\/div>\n\n\t<div id=\"areas-discord\" class=\"legend cloak\">\n\t\t<div class=\"aod-opener\"><\/div>\n\t\t<div class=\"aod-content\"><\/div>\n\t<\/div>\n\t<div class=\"logo-wrap\">\n\t\t<div class=\"widget widget_media_image\"><div class=\"widget-content\"><a href=\"\/\"><img loading=\"lazy\" decoding=\"async\" width=\"250\" height=\"250\" src=\"https:\/\/tiro.expert\/wp-content\/uploads\/2021\/01\/TIRO-monogram-logo@3x-e1610777576269.png\" class=\"image wp-image-1039  attachment-full size-full\" alt=\"TIRO Thyroid International Recommendations Online monogram logo\" style=\"max-width: 100%; height: auto;\" srcset=\"https:\/\/tiro.expert\/wp-content\/uploads\/2021\/01\/TIRO-monogram-logo@3x-e1610777576269.png 250w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/01\/TIRO-monogram-logo@3x-e1610777576269-150x150.png 150w\" sizes=\"auto, (max-width: 250px) 100vw, 250px\" \/><\/a><\/div><\/div>\t<\/div>\n\t<div class=\"site-nav\">\n\t\t<div class=\"menu-primary-tiro-container\"><ul id=\"menu-primary-tiro\" class=\"menu\"><li id=\"menu-item-3048\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children menu-item-3048\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/\" data-ps2id-api=\"true\">Care Recommendations<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-4432\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-4432\"><a href=\"#\" data-ps2id-api=\"true\">Differentiated Thyroid Cancer<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-1987\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1987\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/initial-evaluation-of-thyroid-nodules\/\" data-ps2id-api=\"true\">Initial Evaluation of Thyroid Nodules<\/a><\/li>\n\t\t<li id=\"menu-item-1986\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1986\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/initial-management\/\" data-ps2id-api=\"true\">Initial Management<\/a><\/li>\n\t\t<li id=\"menu-item-1983\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1983\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/initial-staging-response-to-therapy\/\" data-ps2id-api=\"true\">Initial Staging &#038; Response to Therapy<\/a><\/li>\n\t\t<li id=\"menu-item-1984\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1984\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/systemic-therapy\/\" data-ps2id-api=\"true\">Systemic Therapy<\/a><\/li>\n\t\t<li id=\"menu-item-1985\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1985\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/use-of-rai\/\" data-ps2id-api=\"true\">Use of Radioactive Iodine<\/a><\/li>\n\t\t<li id=\"menu-item-1982\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1982\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/recurrent-persistent-disease\/\" data-ps2id-api=\"true\">Recurrent &#038; Persistent Disease<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-4433\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-4433\"><a href=\"#\" data-ps2id-api=\"true\">Medullary Thyroid Cancer<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-4465\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4465\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/initial-evaluation-of-thyroid-nodules-suspicious-of-mtc\/\" data-ps2id-api=\"true\">Initial Evaluation of Thyroid Nodules Suspicious of MTC<\/a><\/li>\n\t\t<li id=\"menu-item-4467\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4467\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/surgical-management\/\" data-ps2id-api=\"true\">Surgical Management<\/a><\/li>\n\t\t<li id=\"menu-item-4862\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4862\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/evaluation-of-advanced-disease\/\" data-ps2id-api=\"true\">Evaluation of Advanced Disease<\/a><\/li>\n\t\t<li id=\"menu-item-4466\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4466\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/management-of-specific-clinical-scenarios\/\" data-ps2id-api=\"true\">Management of Specific Clinical Scenarios<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-4434\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-4434\"><a href=\"#\" data-ps2id-api=\"true\">Anaplastic Thyroid Cancer<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-4502\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4502\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/diagnostic-procedures\/\" data-ps2id-api=\"true\">Diagnostic Procedures<\/a><\/li>\n\t\t<li id=\"menu-item-4501\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4501\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/initial-staging-treatment-planning\/\" data-ps2id-api=\"true\">Initial Staging &#038; Treatment Planning<\/a><\/li>\n\t\t<li id=\"menu-item-4500\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4500\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/surgical-management\/\" data-ps2id-api=\"true\">Surgical Management<\/a><\/li>\n\t\t<li id=\"menu-item-4499\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4499\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/systemic-therapy\/\" data-ps2id-api=\"true\">Systemic Therapy<\/a><\/li>\n\t\t<li id=\"menu-item-4498\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4498\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/end-of-life-care\/\" data-ps2id-api=\"true\">End of Life Care<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-29263\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-29263\"><a href=\"#\" data-ps2id-api=\"true\">Analysis Tools<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-29264\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-29264\"><a href=\"https:\/\/tiro.expert\/es\/ata-2025-risk-of-recurrence-calculator\/\" data-ps2id-api=\"true\">Risk of Recurrence Calculator<\/a><\/li>\n\t\t<li id=\"menu-item-20846\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-20846\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/analysis-tools\/\" data-ps2id-api=\"true\">Anatomic Checklist for Thyroid Cancer<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-1990\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1990\"><a href=\"https:\/\/tiro.expert\/es\/clinical-trial-options\/\" data-ps2id-api=\"true\">Clinical Trial Options<\/a><\/li>\n\t<li id=\"menu-item-3818\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3818\"><a href=\"https:\/\/tiro.expert\/es\/tables-and-figures\/\" data-ps2id-api=\"true\">Tables &#038; Figures<\/a><\/li>\n<\/ul>\n<\/li>\n<li id=\"menu-item-1973\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-1973\"><a href=\"#\" data-ps2id-api=\"true\">Events<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-4348\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4348\"><a href=\"https:\/\/tiro.expert\/es\/webinars\/\" data-ps2id-api=\"true\">Upcoming Webinars<\/a><\/li>\n\t<li id=\"menu-item-20057\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-20057\"><a href=\"https:\/\/tiro.expert\/es\/past-webinars\/\" data-ps2id-api=\"true\">Past Webinars<\/a><\/li>\n\t<li id=\"menu-item-1975\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-1975\"><a href=\"\/subscribe\" data-ps2id-api=\"true\">Subscribe <i class=\"fas fa-external-link-alt fa-xs fa-fw\"><\/i><\/a><\/li>\n<\/ul>\n<\/li>\n<li id=\"menu-item-1974\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-1974\"><a href=\"#\" data-ps2id-api=\"true\">About TIRO<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-1977\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1977\"><a href=\"https:\/\/tiro.expert\/es\/what-is-tiro\/\" data-ps2id-api=\"true\">What is TIRO?<\/a><\/li>\n\t<li id=\"menu-item-2407\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-2407\"><a href=\"https:\/\/tiro.expert\/es\/how-to-use-tiro\/\" data-ps2id-api=\"true\">How to Use TIRO<\/a><\/li>\n\t<li id=\"menu-item-1978\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1978\"><a href=\"https:\/\/tiro.expert\/es\/contact\/\" data-ps2id-api=\"true\">Contact<\/a><\/li>\n\t<li id=\"menu-item-1979\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-1979\"><a href=\"https:\/\/thancguide.org\/\" data-ps2id-api=\"true\">THANC Guide <i class=\"fas fa-external-link-alt fa-xs fa-fw\"><\/i><\/a><\/li>\n\t<li id=\"menu-item-1980\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-1980\"><a href=\"https:\/\/thancfoundation.org\" data-ps2id-api=\"true\">THANC Foundation <i class=\"fas fa-external-link-alt fa-xs fa-fw\"><\/i><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul><\/div>\t<\/div>\n<\/div>\n<div class=\"clinical-outline-mask\"><\/div>\n\n\n\n<h3 class=\"tw-mb-0 wp-block-heading\">Reasons to Enter Patients into Clinical Trials<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ATA \/\/ ESMO \/\/ NCCN<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">High-quality clinical trials for patients with radioiodine refractory differentiated thyroid cancer are important to address clinical uncertainties. A therapeutic clinical trial is a systematic investigation of the effectiveness and safety of a potential new or modified treatment or combination of treatments, potentially including medications (including radioiodine), surgery, radiation therapy, and\/or other novel or revised approaches. A broad variety of such trials may exist at any given time.<span id=\"4643e127-3853-44eb-aca0-62ea91a76ad5\" data-items=\"[&quot;1669419985&quot;,&quot;454795586&quot;,&quot;1160858975&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1\u20133\u200b<\/sup><\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Clinical trial participation is strongly encouraged for all patients with thyroid cancer in need of treatment, especially when standard treatment options offer limited efficacy and\/or risk significant treatment-related morbidity.<span id=\"2604657e-6a91-4e1f-8d09-6cdfdade3f1f\" data-items=\"[&quot;1669419985&quot;,&quot;454795586&quot;,&quot;1160858975&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1\u20133\u200b<\/sup><\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Clinicians considering referral of patients for trials should review available treatment options and eligibility criteria, preferably through discussions with trial center personnel and review of trial materials at the website: <a href=\"https:\/\/clinicaltrials.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.clinicaltrials.gov<\/a>.<span id=\"f8c712d7-e3f2-4d54-bc7c-21b3257742d9\" data-items=\"[&quot;1669419985&quot;,&quot;454795586&quot;,&quot;1160858975&quot;]\" data-has-children=\"true\" class=\"abt-citation\" contenteditable=\"false\"><sup>\u200b1\u20133\u200b<\/sup><\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The complexity of multidisciplinary treatment and the availability of prospective clinical trials should encourage the clinician to refer patients with structurally progressive Radioiodine Refractory Differentiated Thyroid Cancer&nbsp; (RR-DTC) to tertiary centers with particular expertise when feasible.<span id=\"458147f0-777f-452d-9abd-1edee5054aad\" data-items=\"[&quot;1669419985&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1\u200b<\/sup><\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Molecular testing for tumor genotype has been shown to be beneficial when making targeted therapy decisions, including clinical trial participation, based on NCCN guidelines. ATA guidelines, however, state, \u201croutine mutation profiling cannot be recommended at this time outside of research settings.\u201d<span id=\"c5061c01-3427-4ef8-900b-95e9b767d0e3\" data-items=\"[&quot;1669419985&quot;,&quot;1160858975&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1,3\u200b<\/sup><\/span><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Medullary Thyroid Cancer<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Clinical trials have advanced much of what we know today in medullary thyroid carcinoma and ongoing and future trials will be vital to advancing our knowledge and finding a cure for medullary thyroid carcinoma.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Given that patients with medullary thyroid carcinoma have no cure other than surgery, clinical trials should be considered for treatment of distant metastatic disease and unresectable\/ incurable medullary thyroid carcinoma. Clinical trials using radiolabeled therapies, targeted therapies or neoadjuvant therapies are underway and soon to be published. <span id=\"57995cd9-657b-47eb-8bd2-12ea84a35cde\" data-items=\"[&quot;1669419985&quot;,&quot;454795586&quot;,&quot;1160858975&quot;,&quot;3102056739&quot;]\" data-has-children=\"true\" class=\"abt-citation\" contenteditable=\"false\"><sup>\u200b1\u20134\u200b<\/sup><\/span><\/p>\n\n\n\n<div class=\"wp-block-group edu-info tw-rounded has-white-background-color has-background tw-shadow\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-genesis-blocks-gb-accordion gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Expert Commentary\u00a0<\/summary><div class=\"gb-accordion-text\">\n<p class=\"wp-block-paragraph\">Given the available systemic therapies are not cures, progression is inevitable. There is not much known about the mechanisms of resistance at the time of progression. Therefore, biopsy of progressing lesions would be recommended at the time of progression for biomarker testing and determine potential new therapies.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In addition, many of these therapies are taken for long durations, quality of life measures are important. Patient reported outcome measures are encouraged to be investigated and incorporated in clinical trials.&nbsp;<\/p>\n<\/div><\/details><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-group alignfull has-subtle-background-background-color has-background\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-group tw-mb-0 tw-mt-0\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<section aria-label=\"Bibliography\" class=\"wp-block-abt-bibliography abt-bibliography\" role=\"region\"><h3 class=\"abt-bibliography__heading\">References<\/h3><ol class=\"abt-bibliography__body\" data-entryspacing=\"1\" data-maxoffset=\"3\" data-linespacing=\"1\" data-second-field-align=\"flush\"><li id=\"1669419985\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">1. <\/div><div class=\"csl-right-inline\">Haugen B, Alexander E, Bible K, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. <i>Thyroid<\/i>. 2016;26(1):1-133. doi:<a href=\"https:\/\/doi.org\/10.1089\/thy.2015.0020\">10.1089\/thy.2015.0020<\/a><\/div>\n  <\/div>\n<\/li><li id=\"454795586\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">2. <\/div><div class=\"csl-right-inline\">Filetti S, Durante C, Hartl D, et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up\u2020. <i>Ann Oncol<\/i>. 2019;30(12):1856-1883. doi:<a href=\"https:\/\/doi.org\/10.1093\/annonc\/mdz400\">10.1093\/annonc\/mdz400<\/a><\/div>\n  <\/div>\n<\/li><li id=\"1160858975\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">3. <\/div><div class=\"csl-right-inline\">Haddad RI, Nasr C, Bischoff L, et al. NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018. <i>J Natl Compr Canc Netw<\/i>. Published online December 2018:1429-1440. doi:<a href=\"https:\/\/doi.org\/10.6004\/jnccn.2018.0089\">10.6004\/jnccn.2018.0089<\/a><\/div>\n  <\/div>\n<\/li><li id=\"3102056739\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">4. <\/div><div class=\"csl-right-inline\">Ito Y, Onoda N, Okamoto T. The revised clinical practice guidelines on the management of thyroid tumors by the Japan Associations of Endocrine Surgeons: Core questions and recommendations for treatments of thyroid cancer. <i>Endocr J<\/i>. 2020;67(7):669-717. doi:<a href=\"https:\/\/doi.org\/10.1507\/endocrj.EJ20-0025\">10.1507\/endocrj.EJ20-0025<\/a><\/div>\n  <\/div>\n<\/li><\/ol><\/section>\n<\/div><\/div>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Razones para incluir a los pacientes en ensayos cl\u00ednicos ATA \/\/ ESMO \/\/ NCCN Los ensayos cl\u00ednicos de alta calidad para pacientes con c\u00e1ncer diferenciado de tiroides refractario al radioyodo son importantes para abordar las incertidumbres cl\u00ednicas. 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