摘要
目的 探讨手术及放化疗结合的综合治疗对甲状腺未分化癌的临床意义.方法 对2002年1月以来收治18例甲状腺未分化癌患者的临床资料进行回顾性分析.结果 3例Ⅳa期患者均接受甲状腺癌根治＋淋巴结清扫术,术后辅以局部放疗和静脉化疗,其中1例术后34个月死亡,另2例已分别存活27个月、68个月;14例Ⅳb期患者中,除放化疗外,行联合颈前肌或胸锁乳突肌的根治性切除术3例,生存时间分别为16、11、20个月,肿瘤姑息性部分切除术2例,生存时间分别为10、7个月,其余9例未手术或仅行探查、活检性手术,生存时间分别为7、5、8、5、9、2、12（仍存活）、7、6个月;1例Ⅳc期的患者因肿块较大未行手术,且对放化疗均不敏感,于确诊后2个月死于全身衰竭.结论 对甲状腺未分化癌应综合采用手术、放疗和化疗等各种治疗手段,以达到延长患者生命、改善生活质量的目的.
Objective To investigate the clinical significance of comprehensive treatment com- bined with operation, radiotherapy and chemotherapy for anaplastic thyroid carcinoma （ ATC ）. Methods The clinical data of 18 ATC cases from January 2002 to now were analyzed retrospectively. Results Three patients with stage 1V cancer received radical thyroidectomy and lymphadenectomy. After operation, local radiotherapy and intravenous chemotherapy were performed. One patient died at the 34th postoperative month, and the other 2 patients have been living for 27 and 68 months ; In 14 patients with stage IV b, 3 pa- tients received extensive radical excision including anterior jugular muscles or sternocleidomastoid muscles and the survival time was 16 months, 11 months,and 20 months respectively ,2 patients received palliative partial resection and the survival time was 10 months and 7 months respectively, and the remaining 9 pa- tients received only explorative operation or biopsy and the survival time was 7 months, 5 months, 8 months, 5 months,9 months,2 months, 12 months （ still alive） ,7 months and 6 months respectively ; 1 pa- tient in stage IVc didnt receive operation because her tumor was too large, and she was insensitive to either radiotherapy or chemotherapy and died of systemic failure 2 months after diagnosis. Conclusion Compre- hensive treatment that combining operation, radiotherapy and chemotherapy should be used to prolong ATC patients＇life and improve their living quality.
出处
《临床外科杂志》
2012年第7期464-466,共3页
Journal of Clinical Surgery
关键词
甲状腺肿瘤
未分化癌
综合疗法
thyroid tumor
anaplastic cancer
comprehensive treatment
