转移性间变性甲状腺癌原发灶放疗。
Radiation to the Primary Tumor in Metastatic Anaplastic Thyroid Cancer.
机构信息
Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.
Department of Internal Medicine IV, University Hospital, LMU Munich, Munich, Germany.
出版信息
In Vivo. 2021 Jan-Feb;35(1):461-465. doi: 10.21873/invivo.12279.
BACKGROUND/AIM: Metastatic anaplastic thyroid cancer is associated with a dismal prognosis. We evaluated outcome and prognostic factors in patients receiving radiation to the primary tumor in metastatic anaplastic thyroid cancer (ATC).
PATIENTS AND METHODS
All consecutive patients with metastatic ATC (n=20) undergoing irradiation between 2009 and 2019 for anaplastic thyroid cancer were investigated.
RESULTS
Median survival time and median progression-free survival were 2 (range=1-22) and 2 (1-20) months. In univariate analyses, surgery, concurrent or sequential chemotherapy and higher radiation dose escalation (>39 Gy) were correlated with longer overall survival (p=0.005, p=0.018 and p=0.038), respectively. Karnofsky performance status >70% showed a trend of longer survival time (p=0.062). Limited metastatic disease, surgery and concurrent/sequential chemotherapy are correlated with longer progression-free survival times (p=0.043, p=0.024 and p=0.039), respectively.
CONCLUSION
Radiation to the primary tumor in metastatic anaplastic thyroid cancer is safe and offers durable local control. Treatment intensification including concurrent or sequential chemotherapy and radiation dose escalation were associated with longer survival rates and should be considered in selected patients with metastatic disease.
背景/目的：转移性间变性甲状腺癌预后不良。我们评估了转移性间变性甲状腺癌（ATC）患者接受原发病灶放疗的结果和预后因素。
患者和方法
研究了 2009 年至 2019 年间因间变性甲状腺癌接受放疗的 20 例转移性 ATC 连续患者。
结果
中位生存时间和无进展生存时间分别为 2 个月（范围 1-22 个月）和 2 个月（1-20 个月）。单因素分析显示，手术、同期或序贯化疗和更高的放疗剂量递增（>39Gy）分别与总生存期延长相关（p=0.005、p=0.018 和 p=0.038）。卡氏功能状态>70%有延长生存时间的趋势（p=0.062）。局限性转移疾病、手术和同期/序贯化疗与更长的无进展生存时间相关（p=0.043、p=0.024 和 p=0.039）。
结论
转移性间变性甲状腺癌的原发病灶放疗是安全的，并能提供持久的局部控制。包括同期或序贯化疗和放疗剂量递增在内的治疗强化与更长的生存率相关，应在有转移性疾病的选定患者中考虑。
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