肽受体放射性核素治疗晚期碘难治性分化型甲状腺癌和转移性甲状腺髓样癌的疗效和安全性：系统评价。
Efficacy and safety of peptide receptor radionuclide therapy in advanced radioiodine-refractory differentiated thyroid cancer and metastatic medullary thyroid cancer: a systematic review.
机构信息
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science (IUMS), No. 10, Firoozeh St, Vali-asr Ave, Vali-asr Sq, Tehran, 1593716615, Iran.
Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.
出版信息
BMC Cancer. 2021 May 20;21(1):579. doi: 10.1186/s12885-021-08257-x.
BACKGROUND
It has been shown that a subgroup of patients with differentiated thyroid cancer (DTC) and medullary thyroid carcinoma (MTC) would progress to advanced stages of thyroid cancer. Therefore, the present study was done to systematically review available evidence in order to investigate efficacy and safety of peptide receptor radionuclide therapy (PRRT) in the patients with advanced radioiodine refractory differentiated thyroid cancer (RR-DTC) and metastatic MTC.
METHODS
For this purpose, relevant studies investigated safety and efficacy of PRRT in the patients with advanced RR-DTC and metastatic MTC were identified by searching Medline (Pubmed, Ovid, and Ebsco), Scopus, Embase, Web of Science, and Cochrane Library databases (from database inception to March 24, 2021). The review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Searching was done independently by two investigators. Two researchers independently extracted the data and any disagreement was adjudicated by consensus. Quality of the studies was assessed using the tool of case reports/series in systematic reviews.
RESULTS
Among 2284 related papers, 41 papers met the inclusion criteria. A total of 157 patients with RR-DTC were treated with PPRT. Biochemical and objective responses (partial and complete) were observed in 25.3 and 10.5% of patients, respectively. Among 220 patients with metastatic MTC, biochemical and objective responses were observed in 37.2 and 10.6% of the patients, respectively. Forty-six deaths were reported in 95 patients with advanced RR-DTC. In addition, 63 deaths were observed in 144 patients with metastatic MTC. Major side effects were reported in 124 patients treated with Y -based agent. In the patients treated with 177Lu-DOTA-TATE and 111In-Octreotide, mild and transient hematologic or renal complications were reported.
CONCLUSION
Findings of the study revealed that in the absence of the established treatment for the patients with RR-DTC and metastatic MTC, PRRT could be effective with few adverse events.
TRIAL REGISTRATION
PROSPERO registration number: CRD42019125245 .
背景
已经表明，分化型甲状腺癌（DTC）和甲状腺髓样癌（MTC）的亚组患者会进展为甲状腺癌的晚期阶段。因此，本研究旨在系统地回顾现有证据，以研究肽受体放射性核素治疗（PRRT）在晚期放射性碘难治性分化型甲状腺癌（RR-DTC）和转移性 MTC 患者中的疗效和安全性。
方法
为此，通过搜索 Medline（Pubmed、Ovid 和 Ebsco）、Scopus、Embase、Web of Science 和 Cochrane Library 数据库（从数据库建立到 2021 年 3 月 24 日），确定了研究 PRRT 在晚期 RR-DTC 和转移性 MTC 患者中的安全性和疗效的相关研究。审查按照系统评价和荟萃分析的首选报告项目（PRISMA）声明进行。由两名研究人员独立进行搜索。两名研究人员独立提取数据，如果存在分歧，则通过协商解决。使用系统评价中的病例报告/系列工具评估研究质量。
结果
在 2284 篇相关论文中，有 41 篇符合纳入标准。共有 157 例 RR-DTC 患者接受了 PPRT 治疗。分别有 25.3%和 10.5%的患者观察到生化和客观反应（部分和完全）。在 220 例转移性 MTC 患者中，分别有 37.2%和 10.6%的患者观察到生化和客观反应。在 95 例晚期 RR-DTC 患者中报告了 46 例死亡。此外，在 144 例转移性 MTC 患者中观察到 63 例死亡。在接受 Y 基药物治疗的 124 例患者中报告了主要副作用。在接受 177Lu-DOTA-TATE 和 111In-Octreotide 治疗的患者中，报告了轻度和短暂的血液学或肾脏并发症。
结论
研究结果表明，在没有针对 RR-DTC 和转移性 MTC 患者的既定治疗方法的情况下，PRRT 可能是有效的，且不良反应较少。
试验注册
PROSPERO 注册号：CRD42019125245。
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