摘要
目的:分析外照射在复发及转移性甲状腺癌患者中的临床疗效及毒副反应。方法:回顾分析2008年1月至2018年1月北京协和医院放疗科收治的复发及转移性甲状腺癌患者64例,转移性甲状腺癌29例,复发性甲状腺癌35例。外照射采用三维适形、调强放疗或立体定向放疗技术。评价全组患者生存、疗效及毒副反应。疗效评估参照VRS主诉疼痛分级法和RECIST1.1实体瘤疗效评价标准。采用Kaplan-Meier法计算生存率,Cox模型进行预后因素分析。结果:中位随访时间38个月,2年和3年的总生存率分别为67.2%(95%CI=0.556~0.787)和51.6%(95%CI=0.394~0.638)。病理类型是影响总生存率的预后因素(HR=0.32,95%CI=0.163~0.629,P=0.001)。40例可测量病灶外照射1个月后和2年的DCR分别为92.5%和60.94%。全组患者均未出现RTOG-3级及以上毒副反应。结论:对于复发及转移性甲状腺癌患者,外照射治疗可明显改善症状、控制局部病灶。
Objective:To investigate the clinical effect and toxic and side effects of external beam radiotherapy in patients with recurrent and metastatic thyroid carcinoma. Methods:A total of 29 patients with metastatic thyroid carcinoma and 35 patients with recurrent thyroid carcinoma,who were admitted to Department of Radiology in Peking Union Medical College Hospital from January 2008 to January 2018,were enrolled. Three-dimensional conformal radiotherapy,intensity-modulated radiotherapy,or stereotactic radiotherapy was applied as the external beam radiotherapy. Patients’survival,clinical outcome,and adverse reactions were evaluated. The Verbal Rating Scale and Response Evaluation Criteria in Solid Tumors(RECIST1.1)were used for outcome evaluation. The Kaplan-Meier method was used to calculate survival rate,and the Cox proportional hazards model was used to analyze prognostic factors. Results:The median follow-up time was 38 months. The 2- and 3-year overall survival rates were 67.2%(95% confidence interval[CI]:0.556-0.787) and 51.6%(95%CI:0.394-0.638),respectively. Pathological type was a prognostic factor for overall survival rate(hazard ratio=0.32, 95%CI:0.163-0.629,P=0.001). As for the 40 patients with measurable lesions,disease control rates after one month and two years of external beam radiotherapy were 92.5% and 60.94%,respectively. No RTOG grade 3 or above toxic and side effects were observed. Conclusion:In patients with recurrent and metastatic thyroid carcinoma,external beam radiotherapy can significantly improve symptoms and control local lesions.
作者
侯晓荣
沈晶
胡克
马佳彬
甄宏楠
张福泉
Hou Xiaarong;Shen Jing;Hu Ke;Ma Jiabin;Zhen Hongnan;Zhang Fuquan(Department of Radiation Oncology,Pecking Union Medical College Hospital,Chinese Academy of Medical Sciences ,Peking Union Medical College)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2018年第12期1600-1604,共5页
Journal of Chongqing Medical University
关键词
甲状腺癌
外照射
复发
转移
预后
thyroid carcinoma
external beam radiotherapy
recurrence
metastasis
prognosis
