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• Inflection Point:
• MD = Xcm & DT = Xy
(Symptomatic tumours)
• MD ≈ 1cm if DT < 1y
(Very Rapid Progressors)
• MD ≈ 1-1.5cm if DT ≈ 1-2y
(Rapid Progressors)
• MD = 1.5-2cm if DT ≈ 2-4y
(Moderate Progressors)
• MD = 1-2cm if DT > 4y
(Slow Progressors)
Tuttle RM, et al. Best Pract Res Clin Endocrinol Metab. 2017;31(3):295-305.
MD=maximum diameter of the sum of target lesions. DT=doubling time of the MD.
Should initiate systemic treatment
Should initiate systemic treatment
depending on tumour volume,
symptoms and locations
Timely start of systemic therapy