Augustin Teresa, Oliinyk Dmytro, Köhler Viktoria Florentine, Rauch Josefine, Belka Claus, Spitzweg Christine, Käsmann Lukas
Department of Radiation Oncology, University Hospital, LMU Munich, 80539 Munich, Germany.
Department of Internal Medicine IV, University Hospital, LMU Munich, 80539 Munich, Germany.
J Clin Med. 2020 Oct 9;9(10):3231. doi: 10.3390/jcm9103231.
The present study aims to evaluate the outcomes and toxicity of elderly anaplastic thyroid cancer (ATC) patients receiving (chemo)radiotherapy, as well as to identify prognostic factors.
A systematic review using the MEDLINE/PubMed and Cochrane databases was performed. Individual data from all eligible studies were extracted, and a pooled analysis ( = 186) was conducted to examine patient characteristics and treatment. All consecutive ATC patients (≥65 years) treated between 2009 and 2019 at our institution were evaluated for outcomes concerning progression-free survival (PFS), overall survival (OS) probabilities and treatment-related toxicity.
The systematic review and pooled analysis identified age as a prognostic factor. The median OS of our patient cohort ( = 26) was three months (range = 0-125). The 6-, 12- and 24-month survival rates were 35%, 22% and 11%, respectively. In the univariate analysis, a Karnofsky performance status of >70%, the Union for International Cancer Control Tumor-Node-Metastasis classification, multimodal therapy and an EQD2 of >49 Gy were correlated with longer OS and PFS. The acute grade 3 toxicity of dysphagia, dyspnea, dermatitis, mucositis and dysphonia was found in 23%, 15%, 12%, 12% and 8% of patients.
Age appears to be a prognostic factor in ATC. Elderly ATC patients can tolerate multimodal treatment and achieve a promising outcome. Prospective studies need to confirm our findings.
本研究旨在评估接受（化疗）放疗的老年间变性甲状腺癌（ATC）患者的治疗效果和毒性反应，并确定预后因素。
使用MEDLINE/PubMed和Cochrane数据库进行系统评价。提取所有符合条件研究的个体数据，并进行汇总分析（n = 186）以检查患者特征和治疗情况。对2009年至2019年在我院接受治疗的所有连续ATC患者（≥65岁）进行无进展生存期（PFS）、总生存期（OS）概率和治疗相关毒性反应的评估。
系统评价和汇总分析确定年龄为预后因素。我们患者队列（n = 26）的中位总生存期为3个月（范围 = 0 - 125）。6个月、12个月和24个月生存率分别为35%、22%和11%。单因素分析中，卡诺夫斯基表现状态>70%、国际癌症控制联盟肿瘤-淋巴结-转移分类、多模式治疗以及等效剂量2（EQD2）>49 Gy与更长的总生存期和无进展生存期相关。23%、15%、12%、12%和8%的患者出现吞咽困难、呼吸困难、皮炎、粘膜炎和声音嘶哑的3级急性毒性反应。
年龄似乎是ATC的一个预后因素。老年ATC患者能够耐受多模式治疗并取得较好的治疗效果。前瞻性研究需要证实我们的发现。
