Saeed Nadia A, Kelly Jacqueline R, Deshpande Hari A, Bhatia Aarti K, Burtness Barbara A, Judson Benjamin L, Mehra Saral, Edwards Heather A, Yarbrough Wendell G, Peter Patricia R, Holt Elizabeth H, Decker Roy H, Husain Zain A, Park Henry S
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut.
Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut.
Head Neck. 2020 May;42(5):1031-1044. doi: 10.1002/hed.26086. Epub 2020 Feb 3.
EBRT in resected, nonmetastatic anaplastic thyroid cancer (ATC) remains undefined. We evaluated patterns/outcomes with EBRT and chemotherapy in this setting.
This retrospective analysis included patients identified from the National Cancer Database with nonmetastatic ATC from 2004 to 2014 who underwent non-palliative resection.
Our analysis included 496 patients, including 375 who underwent adjuvant EBRT (among whom 198 received concurrent chemotherapy). The median age was 68 years. On MVA, EBRT was associated with sex (OR 0.5, 95% CI 0.3-0.8, P = .002) and income (OR 2.2, 95% CI 1.4-3.3, P < .001). EBRT was associated with longer OS on UVA (12.3 vs 9.1 months, P = .004) and MVA (HR 0.7 [CI 0.6-0.9], P = .004). Concurrent chemoradiation was associated with longer OS on UVA (14.0 vs 9.1 months, P = .003) and MVA (HR 0.6 [CI 0.5-0.8], P < .001).
Adjuvant EBRT is associated with longer OS in resected, nonmetastatic ATC, with additional improved survival with concurrent chemotherapy.
对于接受手术切除的非转移性间变性甲状腺癌（ATC），外照射放疗（EBRT）的作用仍不明确。我们评估了在此情况下EBRT联合化疗的模式及疗效。
这项回顾性分析纳入了2004年至2014年间美国国立癌症数据库中确诊的接受了非姑息性手术切除的非转移性ATC患者。
我们的分析纳入了496例患者，其中375例接受了辅助性EBRT（其中198例接受了同步化疗）。中位年龄为68岁。多因素分析显示，EBRT与性别（比值比[OR]0.5，95%置信区间[CI]0.3 - 0.8，P = 0.002）和收入（OR 2.2，95% CI 1.4 - 3.3，P < 0.001）相关。单因素分析显示，EBRT与更长的总生存期（OS）相关（12.3个月 vs 9.1个月，P = 0.004），多因素分析也显示（风险比[HR]0.7[CI 0.6 - 0.9]，P = 0.004）。同步放化疗与更长的OS在单因素分析中相关（14.0个月 vs 9.1个月，P = 0.003），多因素分析同样显示（HR 0.6[CI 0.5 - 0.8]，P < 0.001）。
辅助性EBRT与接受手术切除的非转移性ATC患者更长的OS相关，同步化疗可进一步提高生存率。
