颈部超声联合血清甲状腺球蛋白评估阿帕替尼治疗进展性碘难治性分化型甲状腺癌的短期疗效

doi:10.19401/j.cnki.1007-3639.2019.06.003

中国癌症杂志 ›› 2019, Vol. 29 ›› Issue (6): 418-422.doi: 10.19401/j.cnki.1007-3639.2019.06.003

颈部超声联合血清甲状腺球蛋白评估阿帕替尼治疗进展性碘难治性分化型甲状腺癌的短期疗效

高璐滢¹，林岩松²，姜玉新¹，李建初¹，李慧²，张波³，刘如玉¹，席雪华¹，高琼¹，王莹¹，赵瑞娜¹

1. 中国医学科学院北京协和医学院北京协和医院超声医学科，北京100730 ；
2. 中国医学科学院北京协和医学院北京协和医院核医学科，北京100730
3. 中日友好医院超声医学科，北京 100029

出版日期:2019-06-30 发布日期:2019-07-12
通信作者: 张波 E-mail: thyroidus@163.com
基金资助:
国家自然科学基金（81571714；81771875）。

Evaluation of short-term efficacy of apatinib using cervical ultrasound and thyroglobulin in the treatment of progressive radioactive iodine-refractory differentiated thyroid cancer

GAO Luying¹, LIN Yansong², JIANG Yuxin¹, LI Jianchu¹, LI Hui², ZHANG Bo³, LIU Ruyu¹, XI Xuehua¹, GAO Qiong¹, WANG Ying¹, ZHAO Ruina¹

1.Department of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; 2. Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; 3. Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China

Published:2019-06-30 Online:2019-07-12
Contact: ZHANG Bo E-mail: thyroidus@163.com

摘要/Abstract

摘要： 背景与目的：放射性碘难治性分化型甲状腺癌患者（radioactive iodine-refractory differentiated thyroid cancer，RAIR-DTC）的治疗方案有限。结合甲状腺癌血清标志物甲状腺球蛋白（thyroglobulin，Tg），评估阿帕替尼对RAIR-DTC颈部淋巴结转移的治疗效果。方法：2016年1月—2017年12月前瞻性纳入9例成人RAIR-DTC患者，口服阿帕替尼（750mg，每天1次）。持续给药直至病情进展或不能耐受药物引起的不良事件。超声定期监测颈部可疑转移淋巴结的变化，并每2周观察血清Tg的水平变化。结果：该研究9例患者中，男性5例，女性4例，平均年龄52.6（33.0~65.0）岁。颈部可疑淋巴结的最大者的最大径基线均值为29.1 mm，经阿帕替尼治疗8~12周后最大径均值为20.0 mm，平均同比下降31.3%。8例Tg可评价的患者中，全部（100%）经阿帕替尼治疗后Tg水平下降，较基线平均同比下降96.3%。结论：从超声检测颈部转移淋巴结及血清学Tg的变化，证实阿帕替尼可用于RAIR-DTC的治疗。

关键词: 阿帕替尼, 放射性碘难治性甲状腺癌, 超声, 甲状腺球蛋白

Abstract: Background and purpose: Radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) is a big challenge in the treatment of thyroid cancer. This study aimed to evaluate the therapeutic effect of apatinib mesylate in the treatment of RAIRDTC cervical lymph node metastasis combined with thyroglobulin (Tg), a serum marker of thyroid cancer. Methods: Nine patients who were diagnosed as having progressive RAIR-DTC were enrolled in this study from Jan. 2016 to Dec. 2017. Patients received oral apatinib 750 mg once a day. Patients continued to be treated until the disease progressed or they were unable to tolerate adverse events. Cervical ultrasound were performed, and serum Tg levels were measured regularly after apatinib treatment to evaluate the response. Results: Of the 9 patients in this study, 5 were males and 4 were females with an average age of 52.6 (33-65) years. The baseline average maximum diameter of the largest metastatic cervical lymph nodes was 29.1 mm, and the average maximum diameter was 20.0 mm after 8 to 12 weeks of apatinib treatment. A mean decline of 31.3% could be observed. Of the 8 patients with evaluable Tg, all (100%) patients had a decrease in Tg levels after treatment with apatinib, which was 96.3% lower than the baseline. Conclusion: Ultrasound detection of metastatic cervical lymph node combined with serum Tg level, confirms that apatinib can be used for the treatment of RAIR-DTC.

Key words: Apatinib, Radioactive iodine-refractory differentiated thyroid cancer, Ultrasound, Thyroglobulin

高璐滢，林岩松，姜玉新，李建初，李慧，张波，刘如玉，席雪华，高琼，王莹，赵瑞娜. 颈部超声联合血清甲状腺球蛋白评估阿帕替尼治疗进展性碘难治性分化型甲状腺癌的短期疗效[J]. 中国癌症杂志, 2019, 29(6): 418-422.

GAO Luying, LIN Yansong, JIANG Yuxin, LI Jianchu, LI Hui, ZHANG Bo, LIU Ruyu, XI Xuehua, GAO Qiong, WANG Ying, ZHAO Ruina. Evaluation of short-term efficacy of apatinib using cervical ultrasound and thyroglobulin in the treatment of progressive radioactive iodine-refractory differentiated thyroid cancer[J]. China Oncology, 2019, 29(6): 418-422.

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颈部超声联合血清甲状腺球蛋白评估阿帕替尼治疗进展性碘难治性分化型甲状腺癌的短期疗效

Evaluation of short-term efficacy of apatinib using cervical ultrasound and thyroglobulin in the treatment of progressive radioactive iodine-refractory differentiated thyroid cancer

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