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甲状腺癌脑转移患者的临床特征、治疗和长期预后。

Clinical characteristics, treatment, and long-term outcome of patients with brain metastases from thyroid cancer.

机构信息

Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.

Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria.

出版信息

Clin Exp Metastasis. 2023 Jun;40(3):217-226. doi: 10.1007/s10585-023-10208-8. Epub 2023 May 23.

Abstract

Brain metastases (BM) in patients with thyroid cancer (TC) are rare with an incidence of 1% for papillary and follicular, 3% for medullary and up to 10% for anaplastic TC (PTC, FTC, MTC and ATC). Little is known about the characteristics and management of BM from TC. Thus, we retrospectively analyzed patients with histologically verified TC and radiologically verified BM identified from the Vienna Brain Metastasis Registry. A total of 20/6074 patients included in the database since 1986 had BM from TC and 13/20 were female. Ten patients had FTC, 8 PTC, one MTC and one ATC. The median age at diagnosis of BM was 68 years. All but one had symptomatic BM and 13/20 patients had a singular BM. Synchronous BM at primary diagnosis were found in 6 patients, while the median time to BM diagnosis was 13 years for PTC (range 1.9-24), 4 years for FTC (range 2.1-41) and 22 years for the MTC patient. The overall survival from diagnosis of BM was 13 months for PTC (range 1.8-57), 26 months for FTC (range 3.9-188), 12 years for the MTC and 3 months for the ATC patient. In conclusion, development of BM from TC is exceedingly rare and the most common presentation is a symptomatic single lesion. While BM generally constitute a poor prognostic factor, individual patients experience long-term survival following local therapy.

摘要

脑转移(BM)在甲状腺癌(TC)患者中较为罕见,其发生率为乳头状和滤泡状癌的 1%,髓样癌的 3%,间变性甲状腺癌(PTC、FTC、MTC 和 ATC)的 10%。对于 TC 引起的 BM 的特征和治疗方法知之甚少。因此,我们回顾性分析了自 1986 年以来维也纳脑转移登记处中经组织学证实的 TC 和经影像学证实的 BM 的患者。数据库中共纳入 6074 例患者,其中 20 例有 TC 引起的 BM,其中 13 例为女性。10 例为 FTC,8 例为 PTC,1 例为 MTC,1 例为 ATC。BM 诊断时的中位年龄为 68 岁。除 1 例外,所有患者均有症状性 BM,20 例患者中有 13 例为单发 BM。6 例患者在初次诊断时即存在同步性 BM,而 PTC 的 BM 中位诊断时间为 13 年(范围为 1.9-24 年),FTC 为 4 年(范围为 2.1-41 年),MTC 为 22 年。PTC 从 BM 诊断开始的总生存期为 13 个月(范围为 1.8-57 个月),FTC 为 26 个月(范围为 3.9-188 个月),MTC 为 12 年,ATC 为 3 个月。总之,TC 发生 BM 极为罕见,最常见的表现为症状性单发病变。虽然 BM 通常构成预后不良的因素,但个别患者在接受局部治疗后可长期生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4f4/10232560/b5834f0173e7/10585_2023_10208_Fig1_HTML.jpg

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