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体能状态和脑外转移部位数量可预测甲状腺癌脑转移放疗后的生存情况。

Performance Status and Number of Metastatic Extra-cerebral Sites Predict Survival After Radiotherapy of Brain Metastases from Thyroid Cancer.

作者信息

Dziggel Liesa, Gebauer Niklas, Bartscht Tobias, Schild Steven E, Rades Dirk

机构信息

Department of Radiation Oncology and Hematology, University of Lübeck, Lübeck, Germany.

Department of Medical Oncology, University of Lübeck, Lübeck, Germany.

出版信息

Anticancer Res. 2018 Apr;38(4):2391-2394. doi: 10.21873/anticanres.12488.

DOI:10.21873/anticanres.12488

PMID:29599366

Abstract

BACKGROUND/AIM: Patients with brain metastases from thyroid cancer are extremely rare. This study evaluated clinical factors for survival following whole-brain radiotherapy (WBRT) alone.

PATIENTS AND METHODS

In six patients, the following factors were analyzed for survival: Regimen of WBRT (5×4 Gy vs. 10×3 Gy), gender, age (≤55 vs. ≥56 years), Karnofsky performance score (KPS) (60% vs. 70-80%), number of brain lesions (2-3 vs. ≥4) and number of extra-cranial metastatic sites (one vs. more than one).

RESULTS

KPS 70-80% (p=0.036) and involvement of only one extra-cranial site (p=0.018) were associated with better survival on univariate analysis. On Cox regression analysis, KPS (p=0.14) and number of extra-cranial sites (p=0.14) showed trends for association with survival. In patients with KPS 70-80% and only one extra-cranial site, 6-month survival was 100%, no patient with KPS 60% and more than one extra-cranial site survived to 6 months.

CONCLUSION

KPS and number of involved extra-cranial metastatic sites were associated with survival and may be helpful for individualizing therapy in patients with brain metastases from thyroid cancer.

摘要

背景/目的：甲状腺癌脑转移患者极为罕见。本研究评估了单纯全脑放疗（WBRT）后的生存临床因素。

患者与方法

对6例患者的以下因素进行生存分析：WBRT方案（5×4 Gy与10×3 Gy）、性别、年龄（≤55岁与≥56岁）、卡诺夫斯基体能状态评分（KPS）（60%与70 - 80%）、脑转移瘤数量（2 - 3个与≥4个）及颅外转移部位数量（1个与多于1个）。

结果

单因素分析显示，KPS 70 - 80%（p = 0.036）及仅1个颅外转移部位（p = 0.018）与较好的生存相关。Cox回归分析显示，KPS（p = 0.14）及颅外转移部位数量（p = 0.14）显示出与生存相关的趋势。KPS 70 - 80%且仅1个颅外转移部位的患者，6个月生存率为100%，无KPS 60%且多于1个颅外转移部位的患者存活至6个月。