现实世界实践模式和RAI耐火差异化甲状腺癌的结果
Andrew G Gianoukakis1, Jennifer H Choe2, Daniel W Bowles3
1The Lundquist Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, California, USA.
European thyroid journal
|December 14, 2023
概括
活跃监测对于患有渐进性放射性耐火分化甲状腺癌的患者来说是一个可行的选择. 然而,早期的多酶抑制剂疗法可能对一些患者有好处,因此需要进一步研究以选择最佳治疗方法.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 对放射性 (RAI-R) 耐火的差异化甲状腺癌 (DTC) 提出了治疗挑战.
- 在渐进的RAI-R DTC患者中,启动多酶抑制剂 (MKIs) 的最佳时间尚未确定.
- 评估了无症状,渐进的RAI-R DTC患者的现实实践模式和结果.
研究的目的:
- 为了比较MKI治疗的现实实践模式与渐进RAI-R DTC患者的积极监测.
- 评估积极监测管理的患者的症状进展时间 (TTSP),与早期MKI启动相比.
- 为了确定美国和非美国患者群体之间结果的潜在差异.
主要方法:
- 这是一项前性,非干预性,开放性研究,涉及患有渐进性RAI-R DTC的患者.
- 患者被医生分配到MKI治疗 (队列1) 或主动监测 (队列2) 中.
- 主要终点是症状进展的时间 (TTSP);对于不可估量的终点,计算了36个月的比率.
主要成果:
- 在647名患者中,478名 (74%) 参与了积极监测队列,169名 (26%) 接受了MKI治疗.
- 与非美国患者 (66.9%) 相比,美国患者的积极监测率更高 (92.6%).
- 在第2队列中,36个月TTSP的发病率相似 (65.6%的美国人与66.5%的非美国人);然而,后来的MKI治疗在第2队列中显示出较低的TTSP发病率 (30.8%的美国人与55.8%的非美国人).
结论:
- 积极监测是无症状患者的可行的管理策略,患者的RAI-R DTC进展.
- 早期MKI干预可能对某些患者亚组更有益.
- 需要进一步的研究来确定特定的患者特征,这些特征可以预测积极监测与早期MKI治疗的最佳反应.
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