Teller P H, Voss A C
Strahlentherapie. 1984 Jun;160(6):349-56.
The treatment results of percutaneous radiotherapy of 85 patients with thyroid malignomas treated between 1972 and 1979 are presented in a retrospective study. 49 patients were treated for curative purposes, 36 patients suffering from metastases were submitted to palliative therapy. Primary radiotherapy was performed as pendulum or oblique-field irradiation up to 60 Gy, and patients with metastases or local recurrences were submitted to stationary-field or contralateral irradiation up to 40 (-50) Gy depending on the tumor site. In both groups, prognosis and survival time depend much more on the histologic differentiation than on the tumor dimension and the age of the patient. If the thyroid malignomas were well differentiated, we observed survival times of several years, even in case of extended, eventually filiarized tumors. On the other hand, the average survival time of patients with dedifferentiated thyroid tumors was only four months, with even worse results in case of only subtotally operable or completely inoperable anaplastic tumors. In these cases we should like to avoid an indication for percutaneous radiotherapy and to recommend, if possible, palliative surgical measures the effect of which will be seen more rapidly.
一项回顾性研究展示了1972年至1979年间接受经皮放射治疗的85例甲状腺恶性肿瘤患者的治疗结果。49例患者接受了根治性治疗，36例发生转移的患者接受了姑息性治疗。原发性放射治疗采用钟摆式或斜野照射，剂量达60 Gy，发生转移或局部复发的患者根据肿瘤部位接受固定野或对侧照射，剂量达40（-50）Gy。在两组中，预后和生存时间更多地取决于组织学分化程度，而非肿瘤大小和患者年龄。如果甲状腺恶性肿瘤分化良好，即使是肿瘤广泛、最终呈条索状的患者，我们也观察到其生存时间可达数年。另一方面，未分化甲状腺肿瘤患者的平均生存时间仅为四个月，对于仅可进行次全手术或完全无法手术的间变性肿瘤患者，结果更差。在这些情况下，我们应避免进行经皮放射治疗，如有可能，建议采取姑息性手术措施，其效果会更快显现。
