新辅助达拉非尼联合曲美替尼治疗复发性 BRAF V600E 突变型甲状腺乳头状癌的功能性器官保留。
Neoadjuvant dabrafenib and trametinib for functional organ preservation in recurrent BRAF V600E-mutated papillary thyroid cancer.
机构信息
Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, IN, USA.
Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA.
出版信息
Oral Oncol. 2023 Dec;147:106625. doi: 10.1016/j.oraloncology.2023.106625. Epub 2023 Nov 8.
OBJECTIVES
To describe the first reported use of neoadjuvant dabrafenib and trametinib specifically to permit organ conservation surgery in locally advanced recurrent differentiated thyroid carcinoma.
PATIENTS AND METHODS
A patient presented with locally recurrent, radioiodide-resistant DTC with a BRAF V600E mutation invading the laryngotrachea. Definitive treatment would require a total laryngectomy. She was offered neoadjuvant dabrafenib and trametinib prior to surgery.
RESULTS
A significant radiographic response permitted partial laryngectomy, enabling preservation of voice, early resumption of oral feeding, and avoidance of permanent tracheostomy. At 9 months, she remained free of disease.
CONCLUSION
Neoadjuvant tyrosine kinase inhibitor treatment prior to definitive surgery for locally-invasive recurrent DTC is a potential approach that may limit the degree of surgery and associated morbidity.
目的
描述新辅助达拉非尼和曲美替尼治疗局部晚期复发性分化型甲状腺癌以实现保留器官手术的首例报道。
患者与方法
患者出现局部复发性、放射性碘难治性 DTC，BRAF V600E 突变侵犯喉气管。确定性治疗需要全喉切除术。她在手术前接受了新辅助达拉非尼和曲美替尼治疗。
结果
显著的影像学反应允许行部分喉切除术，从而保留了声音，早期恢复经口进食，并避免了永久性气管造口术。9 个月时，患者疾病无进展。
结论
局部侵袭性复发性 DTC 行确定性手术前的新辅助酪氨酸激酶抑制剂治疗是一种可能的方法，可限制手术范围和相关发病率。
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