Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
BMC Cancer. 2020 Dec 2;20(1):1181. doi: 10.1186/s12885-020-07693-5.
Thyroid malignancies are among the most common endocrine cancers worldwide. Owing to the angiogenic nature of these malignancies, tyrosine kinase inhibitors (TKIs) are an attractive potential treatment. However, TKIs have been associated with an increased risk of tumor cavitation, in turn linked to poor outcomes, in patients with malignancies in the lungs, where thyroid cancer commonly metastasizes.
We performe d a retrospective cohort study of patients with thyroid cancer and evidence of metastatic disease to the lung that were treated with multi-targeted antiangiogenic TKIs. The primary objective of this study was to determine the incidence of pulmonary cavitation. The secondary objective was to evaluate the effect of pulmonary cavitation on survival.
Of the 83 patients with pulmonary nodules, 10 developed cavitation during treatment. Of these 83 patients, two patients had to stop the treatment due to pneumothorax. Additionally, cavitation did not demonstrate any significant effect on survival.
In patients with thyroid cancer and evidence of metastatic disease to the chest, the use of multi-targeted TKIs led to cavitations that were not uncommon but clinical consequences were marginal. Treatment was stopped only in two patients that developed pneumothorax, however the small sample is a strong limitation of our study.
甲状腺恶性肿瘤是全球最常见的内分泌癌症之一。由于这些恶性肿瘤的血管生成特性，酪氨酸激酶抑制剂（TKI）是一种有吸引力的潜在治疗方法。然而，TKI 已与肺部恶性肿瘤患者的肿瘤空洞形成风险增加相关，而肿瘤空洞又与不良结局相关，甲状腺癌通常会转移到肺部。
我们对接受多靶点抗血管生成 TKI 治疗的有肺部转移证据的甲状腺癌患者进行了回顾性队列研究。本研究的主要目的是确定肺空洞形成的发生率。次要目的是评估肺空洞形成对生存的影响。
在 83 名有肺部结节的患者中，10 名在治疗过程中出现空洞。在这 83 名患者中，有两名患者因气胸而不得不停止治疗。此外，空洞形成对生存没有任何显著影响。
在有胸部转移证据的甲状腺癌患者中，使用多靶点 TKI 可导致空洞形成，但并不常见，临床后果也较小。只有两名患者因气胸而停止治疗，但小样本是我们研究的一个很大的局限性。
