Zhang Wenxin, Wang Hui, Li Weijian, Jia Qiang, Zhang Ruyi, Tan Jian, Wang Shen, Zhang Ruiguo
Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, China.
Heliyon. 2024 Jul 5;10(13):e34168. doi: 10.1016/j.heliyon.2024.e34168. eCollection 2024 Jul 15.
The effect of combined radiation and chemotherapy (combination therapy) versus monotherapy on anaplastic thyroid carcinoma (ATC) has not yet been clear.
We identified 516 ATC patients during 2010-2015 from the Surveillance, Epidemiology and End Results (SEER) database and evaluated their survival outcome using the Kaplan-Meier method, Cox regression analysis and propensity score matching (PSM) technique.
The median overall survival (OS) among the entire cohort was 3 months (95 % confidence interval [CI], 2.58-3.42 months), and the 6- and 12-month OS rates were 29 % (95 % CI, 25.01%-32.88 %) and 13 % (95 % CI, 10.60%-16.58 %), respectively. Multivariable analysis demonstrated that ATC patients not receiving radiotherapy or chemotherapy were unquestionably associated with worse OS (hazard ratio [HR] 3.000, 95 % CI, 2.390-3.764) and cancer-specific survival (CSS) (HR = 3.107, 95 % CI, 2.388-4.043), compared with those receiving combination therapy. However, combination therapy did not predict better prognosis compared with monotherapy (all > 0.05). After PSM, the median OS and CSS were also not significantly improved in patients undergoing chemoradiotherapy versus chemotherapy alone (OS, = 0.382; CSS, = 0.420) or radiotherapy alone (OS, = 0.065; CSS, = 0.251).
Combination therapy, compared to monotherapy, does not have the expected improvement in survival beyond the benefits achievable with each single-modality treatment, necessitating further prospective research to tailor its treatment management.
联合放疗与化疗（联合治疗）对比单一疗法治疗间变性甲状腺癌（ATC）的效果尚不清楚。
我们从监测、流行病学与最终结果（SEER）数据库中识别出2010年至2015年期间的516例ATC患者，并使用Kaplan-Meier法、Cox回归分析和倾向评分匹配（PSM）技术评估他们的生存结局。
整个队列的中位总生存期（OS）为3个月（95%置信区间[CI]，2.58 - 3.42个月），6个月和12个月的OS率分别为29%（95% CI，25.01% - 32.88%）和13%（95% CI，10.60% - 16.58%）。多变量分析表明，与接受联合治疗的患者相比，未接受放疗或化疗的ATC患者的OS（风险比[HR] 3.000，95% CI，2.390 - 3.764）和癌症特异性生存期（CSS）（HR = 3.107，95% CI，2.388 - 4.043）无疑更差。然而，与单一疗法相比，联合治疗并未预示更好的预后（所有P>0.05）。PSM后，接受放化疗的患者与单纯化疗（OS，P = 0.382；CSS，P = 0.420）或单纯放疗（OS，P = 0.065；CSS，P = 0.251）的患者相比，中位OS和CSS也未显著改善。
与单一疗法相比，联合治疗在生存方面并未带来超出单一治疗方式所能达到的预期改善，因此需要进一步开展前瞻性研究以优化其治疗管理。
