Tsuchida Kodai, Shiga Kiyoto, Katagiri Katsunori, Saito Daisuke, Oikawa Shin-Ichi, Ikeda Aya, Miyaguchi Jun, Kusaka Takahiro
Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan.
Cancer Diagn Progn. 2025 Jan 3;5(1):127-131. doi: 10.21873/cdp.10421. eCollection 2025 Jan-Feb.
BACKGROUND/AIM: The role of lenvatinib as neoadjuvant chemotherapy for patients with advanced thyroid cancer has not been firmly established. In some cases, surgery may be considered when lenvatinib treatment becomes challenging to continue.
We present four cases of unresectable thyroid cancer diagnosed histologically as papillary carcinoma. The patients were a 61-year-old female (T4aN1bM0), a 75-year-old male (T4aN1bM0), a 61-year-old female (T3N1bM0), and a 64-year-old female (T4aN1bM0). Initial lenvatinib doses were 24, 10, 24, and 14 mg/day, respectively. The treatment administration periods were 8, 29, 3, and 6 months, with final doses of 4, 4, 10, and 14 mg/day, respectively. Tumors had primarily invaded the surrounding tissues, mainly the common carotid artery, and were considered unresectable. After lenvatinib administration, tumor shrinkage was observed. Despite complications from lenvatinib that resulted in difficulty in the administration of the drug, successful tumor resection was achieved, and local control was achieved in all patients.
Preoperative lenvatinib treatment may offer a less invasive alternative for advanced thyroid cancer cases that would otherwise require invasive surgery.
背景/目的：乐伐替尼作为晚期甲状腺癌患者新辅助化疗的作用尚未得到明确确立。在某些情况下，当乐伐替尼治疗难以继续进行时，可考虑手术治疗。
我们报告4例经组织学诊断为乳头状癌的不可切除甲状腺癌病例。患者分别为一名61岁女性（T4aN1bM0）、一名75岁男性（T4aN1bM0）、一名61岁女性（T3N1bM0）和一名64岁女性（T4aN1bM0）。乐伐替尼初始剂量分别为24、10、24和14mg/天。治疗给药期分别为8、29、3和6个月，最终剂量分别为4、4、10和14mg/天。肿瘤主要侵犯周围组织，主要是颈总动脉，被认为不可切除。给予乐伐替尼后，观察到肿瘤缩小。尽管乐伐替尼的并发症导致药物给药困难，但仍成功进行了肿瘤切除，所有患者均实现了局部控制。
术前乐伐替尼治疗可能为晚期甲状腺癌病例提供一种侵入性较小的替代方案，否则这些病例需要进行侵入性手术。
