Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
Front Endocrinol (Lausanne). 2021 Sep 16;12:730025. doi: 10.3389/fendo.2021.730025. eCollection 2021.
Brain metastasis from differentiated thyroid cancer has followed a similar increasing trend to that of thyroid cancer in recent years. However, the characteristics and treatments for brain metastases are unclear. The aim of this study was to understand this disease by analyzing patients with brain metastases from differentiated thyroid cancer (DTC).
Between 2000 and 2020, the database of the Sun Yat-sen University Cancer Center was searched for differentiated thyroid cancer patients. We identified a cohort of 22 patients with brain metastases. The characteristics of the patients, histological features, treatments, and time of death were reviewed. The overall survival (OS) rate was calculated using the Kaplan Meier method. Survival curves of different subgroups were compared according to baseline characteristics and treatments received.
A total of 22 (1.09%) out of 2013 DTC patients in the Sun Yat-sen University Cancer Center database were identified as having brain metastases. The overall median survival time was 17.5 months (range from 1-60 months) after diagnosis of brain metastasis. Performance statue (PS), tumor site, and neurosurgery impacted survival, according to Kaplan-Meier analysis. Prognosis of skull metastasis was superior to that of intracranial types. Neurosurgery was the only type of treatment that had an impact on patient OS.
Brain metastasis from differentiated thyroid cancer has a poor prognosis. However, it can be improved by comprehensive treatment. PS of the patients can greatly affect survival. Skull metastases have improved prognosis over intracranial types. Radioiodine therapy (RAIT) appears to effectively improve the prognosis of patients with skull metastases from DTC.
近年来，分化型甲状腺癌脑转移的发生率与甲状腺癌相似，呈上升趋势。然而，脑转移的特征和治疗方法尚不清楚。本研究旨在通过分析分化型甲状腺癌（DTC）脑转移患者来了解这种疾病。
在 2000 年至 2020 年间，检索中山大学肿瘤中心的数据库，寻找分化型甲状腺癌患者。我们确定了 22 例脑转移患者的队列。回顾了患者的特征、组织学特征、治疗方法和死亡时间。使用 Kaplan-Meier 方法计算总生存率（OS）。根据基线特征和接受的治疗方法，比较不同亚组的生存曲线。
中山大学肿瘤中心数据库中共有 22 例（1.09%）2013 例 DTC 患者被诊断为脑转移。脑转移诊断后，中位总生存时间为 17.5 个月（1-60 个月）。根据 Kaplan-Meier 分析，PS、肿瘤部位和神经外科手术影响生存。颅骨转移的预后优于颅内转移类型。神经外科手术是唯一影响患者 OS 的治疗方法。
分化型甲状腺癌脑转移预后较差，但通过综合治疗可以改善。患者的 PS 极大地影响生存。颅骨转移的预后优于颅内转移类型。放射性碘治疗（RAIT）似乎可以有效地改善 DTC 颅骨转移患者的预后。
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