新辅助治疗提高晚期甲状腺癌可切除性的真实世界经验。
Neoadjuvant therapy to improve resectability of advanced thyroid cancer: A real-world experience.
机构信息
Division of Thyroid and Parathyroid Endocrine Surgery, Harvard Medical School, Boston, Massachusetts, USA.
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
出版信息
Head Neck. 2024 Oct;46(10):2496-2507. doi: 10.1002/hed.27735. Epub 2024 Mar 15.
BACKGROUND
Experience with targeted neoadjuvant treatment for locoregionally advanced thyroid cancer is nascent.
METHODS
Multicenter retrospective case series examining targeted neoadjuvant treatment for locoregionally advanced thyroid cancer. The primary outcome was change in surgical morbidity as measured by two metrics developed for use in clinical trials to characterize surgical complexity and morbidity. Secondary outcomes included percentage of patients proceeding to surgery and percentage receiving an R0/R1 resection.
RESULTS
Seventeen patients with varied molecular alterations, pathologies, and treatment regimens were included. Mean surgical complexity scores decreased between time points for baseline and postneoadjuvant treatment, postneoadjuvant treatment and surgery, and between baseline and surgery. Eleven patients (64.7%) underwent surgical resection, with 10 (58.8%) receiving an R0/R1 resection.
CONCLUSIONS
Neoadjuvant treatment of advanced thyroid cancer improves resectability and decreases the morbidity of required surgical procedures. However, treatment is not uniformly effective.
背景
局部晚期甲状腺癌的靶向新辅助治疗经验尚处于初始阶段。
方法
多中心回顾性病例系列研究，旨在研究局部晚期甲状腺癌的靶向新辅助治疗。主要结局指标为通过两项临床试验中用于评估手术复杂性和发病率的指标衡量的手术发病率变化。次要结局指标包括行手术治疗的患者比例和接受 R0/R1 切除术的患者比例。
结果
共纳入了 17 例具有不同分子改变、病理和治疗方案的患者。基线和新辅助治疗后、新辅助治疗后和手术前、基线和手术前的手术复杂性评分均值均降低。11 例（64.7%）患者行手术切除，其中 10 例（58.8%）获得 R0/R1 切除。
结论
晚期甲状腺癌的新辅助治疗可提高可切除性并降低所需手术治疗的发病率。然而，治疗并非普遍有效。
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