Denaro Nerina, Nigro Cristiana Lo, Russi Elvio G, Merlano Marco C
Oncology Department, AO S Croce e Carle, Messina, Italy ; Human Pathology Department, Messina University, Messina, Italy.
Onco Targets Ther. 2013 Sep 16;9:1231-41. doi: 10.2147/OTT.S46545.
Anaplastic thyroid cancer represents 1%-2% of thyroid cancers. For its aggressiveness, it is considered a systemic disease at the time of diagnosis. Surgery remains the cornerstone of therapy in resectable tumor. Traditional chemotherapy has little effect on metastatic disease. A multimodality approach, incorporating cytoreductive surgical resection, chemoradiation, either concurrently or sequentially, and new promising target therapies is advisable. Doxorubicin is the most commonly used agent, with a response rate of 22%. Recently, other chemotherapy agents have been used, such as paclitaxel and gemcitabine, with superimposable activity and response rates of 10%-20%. However, survival of patients with anaplastic thyroid cancer has changed little in the past 50 years, despite more aggressive systemic and radiotherapies. Several new agents are currently under investigation. Some of them, such as sorafenib, imatinib, and axitinib have been tested in small clinical trials, showing promising disease control rates ranging from 35%-75%. Referral of patients for participation in clinical trials is needed.
间变性甲状腺癌占甲状腺癌的1%-2%。因其侵袭性，在诊断时即被视为一种全身性疾病。手术仍然是可切除肿瘤治疗的基石。传统化疗对转移性疾病疗效甚微。建议采用多模式方法，包括减瘤性手术切除、同步或序贯放化疗以及新的有前景的靶向治疗。阿霉素是最常用的药物，有效率为22%。最近，其他化疗药物也被使用，如紫杉醇和吉西他滨，其活性和有效率相当，为10%-20%。然而，尽管采用了更积极的全身治疗和放疗，但在过去50年里，间变性甲状腺癌患者的生存率几乎没有变化。目前有几种新药正在研究中。其中一些，如索拉非尼、伊马替尼和阿昔替尼已在小型临床试验中进行了测试，显示出有前景的疾病控制率，范围为35%-75%。需要将患者转诊以参与临床试验。
