晚期和耐放射性分化的甲状腺癌的临床和治疗模式. 根据ERUDIT的研究结果,
Carlos López López1, Marcel Sambo2, Lorenzo Orcajo-Rincon3
1Department of Medical Oncology, Marqués de Valdecilla University Hospital, IDIVAL, UNICAN, Avda Valdecilla 28, 39008, Santander, Cantabria, Spain. carlos.lopez@scsalud.es.
概括
耐放射性分化的甲状腺癌 (RR-DTC) 在伊比利亚半岛很常见. 新的表现和糟糕的表现状况与更糟糕的生存率有关,而长时间的警觉等待可能会带来好处.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 临床研究 临床研究
背景情况:
- 放射性耐药性 (RR) 疾病显著影响晚期分化甲状腺癌 (aDTC) 的发病率和死亡率.
- 关于伊比利亚半岛RR-DTC的现实世界的纵向数据是有限的.
研究的目的:
- 描述RR-DTC在多中心伊比利亚队列中的临床特征,多学科管理和结果.
- 为了确定预后因素,包括 de novo 与复发/进展性疾病呈现的影响.
主要方法:
- 对来自23个西班牙/葡萄牙中心的213名成年aDTC患者 (2007-2017) 的回顾性分析.
- 对人口统计和临床数据,治疗方法,一线全身疗法 (ST) 的无进展生存率 (PFS) 和整体生存率 (OS) 的评估.
- 探索性疾病死亡多状态马尔科夫模型和卡普兰-梅尔对死亡率的分析.
主要成果:
- 165名患者 (77.5%) 符合RR-DTC标准; 37%接受了ST (主要是索拉费尼布).
- 第一线ST中PFS的中位数为16.0个月;RR-DTC诊断后的中位数是4.7年.
- 在De novo aDTC的生存期较短 (3.0年),而不是复发性/渐进性 eDTC (8.0年). 年龄<55岁,长时间的警等待 (WW) 和更好的绩效状态 (ECOG 0-1) 与更长的OS相关.
结论:
- RR-DTC在伊比利亚地区普遍存在,由多学科团队管理,大量使用WW.
- 从新开始的DTC和糟糕的绩效状态预测了更糟糕的生存率.
- 延长的WW可能与改进的操作系统有关,但潜在的偏差需要前性验证.
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