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索拉非尼和仑伐替尼治疗放射性碘难治性分化型甲状腺癌转移/复发。

Sorafenib and Lenvatinib Treatment for Metastasis/Recurrence of Radioactive Iodine-refractory Differentiated Thyroid Carcinoma.

机构信息

Department of Surgery, Kuma Hospital, Kobe, Japan

Department of Surgery, Kuma Hospital, Kobe, Japan.

出版信息

In Vivo. 2021 Mar-Apr;35(2):1057-1064. doi: 10.21873/invivo.12350.

Abstract

BACKGROUND/AIM: Radioactive iodine-refractory differentiated thyroid carcinoma (RR-DTC) has been treated with multi-kinase inhibitors (MKIs), e.g., sorafenib (SOR) and lenvatinib (LEN). We analyzed the outcomes of RR-DTC patients who underwent SOR or LEN treatment at Kuma Hospital.

PATIENTS AND METHODS

We enrolled 21 and 18 patients treated with SOR and LEN, respectively.

RESULTS

The incidence of partial response in the LEN group was significantly higher than that in the SOR group. Serum thyroglobulin significantly decreased from the beginning of treatment to 1 month later in the LEN group (not in the SOR group). The neutrophil-lymphocyte ratio (NLR) was significantly decreased at 1 month later in both groups. An NLR ≥3 at the start of MKI treatment had a prognostic impact.

CONCLUSION

For RR-DTC, LEN could be more effective than SOR, at least in the short term. The first-line drug should be selected based on other factors (e.g., adverse events, patient background).

摘要

背景/目的:放射性碘难治性分化型甲状腺癌(RR-DTC)已采用多激酶抑制剂(MKIs)治疗,例如索拉非尼(SOR)和仑伐替尼(LEN)。我们分析了熊本医院接受 SOR 或 LEN 治疗的 RR-DTC 患者的结局。

患者和方法

我们分别纳入了 21 例和 18 例接受 SOR 和 LEN 治疗的患者。

结果

LEN 组部分缓解的发生率明显高于 SOR 组。LEN 组的血清甲状腺球蛋白自治疗开始至 1 个月后明显下降(SOR 组则没有)。两组的中性粒细胞-淋巴细胞比值(NLR)在 1 个月后均明显下降。MKI 治疗开始时 NLR≥3 具有预后影响。

结论

对于 RR-DTC,LEN 至少在短期内可能比 SOR 更有效。应根据其他因素(例如不良反应、患者背景)选择一线药物。

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