Wang J F, Zhu X H, Tan Z, Ge M H
Department of Head and Neck Surgery, Zhejiang Province Cancer Hospital, Hangzhou 310022, China.
Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310022, China.
Zhonghua Zhong Liu Za Zhi. 2017 Jun 23;39(6):434-438. doi: 10.3760/cma.j.issn.0253-3766.2017.06.007.
To investigate the clinical characteristics, treatment outcomes and prognostic factors in patients with anaplastic thyroid cancer. Clinical data of 56 patients with anaplastic thyroid cancer at Zhejiang Cancer Hospital from January 2006 to June 2016 were retrospectively reviewed and followed up. Of the 56 patients, there were 24 male and 32 female. The median age was 65 years old. At diagnosis, 10 patients have different degrees of breathing difficulty; 8 patients have varying degrees of dysphagia, and 12 patients have hoarseness. Distant metastases were found in 23 patients at presentation. Patient staging was performed in accordance with the tumor-node-metastasis system as follows: stage ⅣA (=19), stage ⅣB (=14) and stage ⅣC (=23). The median survival time of 56 patients was 4.5 months.The overall 1-year survival rate was 5.4%. Univariate analysis showed that radiotherapy and multimodality therapy were prognostic factors for 1-year overall survival (both of <0.05). The overall 1-year survival rate of the patients who received precision radiotherapy was 16.7%, which was higher than who received the other radiation therapy (4.0%, =0.040). Furthermore, the overall 1-year survival rate of the patients who received surgery combined with radiotherapy was 12.5%, which was higher than who received the other treatments(4.2%, =0.040). Multivariate analysis indicated that radiotherapy was independently associated with improved survival (=0.020). Patients with anaplastic thyroid cancer should receive multimodality therapies combining surgery with radiotherapy. Radiotherapy is independently associated with improved overall survival. Notably, the precision radiotherapy that based on image guidance has a significantly beneficial impact on the prognosis of patients.
研究间变性甲状腺癌患者的临床特征、治疗效果及预后因素。回顾性分析并随访了2006年1月至2016年6月在浙江省肿瘤医院就诊的56例间变性甲状腺癌患者的临床资料。56例患者中，男性24例，女性32例。中位年龄为65岁。诊断时，10例患者有不同程度的呼吸困难；8例患者有不同程度的吞咽困难，12例患者有声音嘶哑。初诊时发现23例患者有远处转移。根据肿瘤-淋巴结-转移系统进行患者分期如下：ⅣA期（=19例）、ⅣB期（=14例）和ⅣC期（=23例）。56例患者的中位生存时间为4.5个月。总体1年生存率为5.4%。单因素分析显示，放疗和多模式治疗是1年总生存的预后因素（均P<0.05）。接受精确放疗患者的总体1年生存率为16.7%，高于接受其他放疗的患者（4.0%，P=0.040）。此外，接受手术联合放疗患者的总体1年生存率为12.5%，高于接受其他治疗的患者（4.2%，P=0.040）。多因素分析表明，放疗与生存改善独立相关（P=0.020）。间变性甲状腺癌患者应接受手术与放疗相结合的多模式治疗。放疗与总体生存改善独立相关。值得注意的是，基于图像引导的精确放疗对患者预后有显著有益影响。
