Murayama Daisuke, Yamamoto Yayoi, Matsui Ai, Yasukawa Mio, Okamoto Saki, Toda Soji, Iwasaki Hiroyuki
Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Department of Diagnostic and Interventional Radiology, Kanagawa Cancer Center, Yokohama, Japan.
Gland Surg. 2022 Jun;11(6):963-969. doi: 10.21037/gs-22-71.
Anaplastic thyroid cancer (ATC) is a rare malignancy with a poor prognosis. It accounts for 1-2% of all thyroid cancers. Lenvatinib is an orally administered inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3, fibroblast growth factor receptor (FGFR)-1 to -4, platelet-derived growth factor receptor (PDGFR)-α, rearranged during transfection (RET), and KIT. There have been cases of pneumothorax caused by lung cavitation and collapse after administration of lenvatinib in ATC with lung metastasis. In this study, we investigate lung cavitation during treatment with lenvatinib in ATC patients with lung metastasis.
All ATC patients with lung metastasis treated at our hospital with lenvatinib between November 2015 and May 2021 were selected from our electronic medical records. The primary objective was to determine the incidence of cavitation of lung metastasis of ATC in patients treated with lenvatinib. The secondary objective was to evaluate prognostic factors in ATC patients with lung metastasis treated with lenvatinib.
We identified 26 patients treated with lenvatinib for ATC with lung metastasis. Of these, 12 (46.2%) had cavitation with lung metastasis during lenvatinib treatment. The median overall survival (OS) was 128 days (79-228 days), and the cavitation (+) group had significantly longer OS than the cavitation (-) group [186 days (117-355 days) 89 days (59-179 days), P=0.033]. Kaplan-Meier survival curves indicated a significant difference in OS was observed between the two groups (P=0.0293). Univariate analysis demonstrated lung cavitation was a significant prognostic factor (hazard ratio: 0.38, 95% CI: 0.16-0.93).
Lung cavitation occurred in 46.2% of patients treated with lenvatinib for ATC with lung metastasis. Patients who developed lung cavitation had a significantly better prognosis than those who did not.
间变性甲状腺癌（ATC）是一种罕见的恶性肿瘤，预后较差。它占所有甲状腺癌的1%-2%。乐伐替尼是一种口服的血管内皮生长因子受体（VEGFR）-1、-2和-3、成纤维细胞生长因子受体（FGFR）-1至-4、血小板衍生生长因子受体（PDGFR）-α、转染重排（RET）和KIT的抑制剂。在患有肺转移的ATC患者中，曾有服用乐伐替尼后因肺空洞形成和肺萎陷导致气胸的病例。在本研究中，我们调查了乐伐替尼治疗伴有肺转移的ATC患者期间的肺空洞形成情况。
从我院电子病历中选取2015年11月至2021年5月期间在我院接受乐伐替尼治疗的所有伴有肺转移的ATC患者。主要目的是确定接受乐伐替尼治疗的患者中ATC肺转移空洞形成的发生率。次要目的是评估接受乐伐替尼治疗的伴有肺转移的ATC患者的预后因素。
我们确定了26例接受乐伐替尼治疗的伴有肺转移的ATC患者。其中，12例（46.2%）在乐伐替尼治疗期间出现肺转移空洞形成。中位总生存期（OS）为128天（79-228天），空洞形成（+）组的OS明显长于空洞形成（-）组[186天（117-355天）对89天（59-179天），P=0.033]。Kaplan-Meier生存曲线表明两组之间的OS存在显著差异（P=0.0293）。单因素分析表明肺空洞形成是一个显著的预后因素（风险比：0.38，95%CI：0.16-0.93）。
在接受乐伐替尼治疗的伴有肺转移的ATC患者中，46.2%出现了肺空洞形成。出现肺空洞形成的患者预后明显好于未出现的患者。
