Application of intensity-modulated radiotherapy in locoregionally advanced and recurrent poorly differentiated thyroid carcinoma

薛　芬; 李端树; 胡超苏

doi:10.19401/j.cnki.1007-3639.2018.03.008

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Application of intensity-modulated radiotherapy in locoregionally advanced and recurrent poorly differentiated thyroid carcinoma

更新时间：2026-01-27

- Application of intensity-modulated radiotherapy in locoregionally advanced and recurrent poorly differentiated thyroid carcinoma
- China Oncology Vol. 28, Issue 3, Pages: 216-221(2018)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院放疗科，复旦大学上海医学院肿瘤学系,上海,200032
  2. 复旦大学附属肿瘤医院头颈外科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2018.03.008
  CLC： R730.55;R736.1
- Published Online：11 April 2018，
  
  Published：11 April 2018
- 稿件说明：
移动端阅览
薛　芬,李端树,胡超苏,等. 调强放疗在局部晚期及复发甲状腺低分化癌中的应用[J]. 中国癌症杂志, 2018, 28(3): 216-221.

薛　芬, 李端树, 胡超苏. Application of intensity-modulated radiotherapy in locoregionally advanced and recurrent poorly differentiated thyroid carcinoma[J]. China Oncology, 2018, 28(3): 216-221.
薛　芬,李端树,胡超苏,等. 调强放疗在局部晚期及复发甲状腺低分化癌中的应用[J]. 中国癌症杂志, 2018, 28(3): 216-221. DOI： 10.19401/j.cnki.1007-3639.2018.03.008.

薛　芬, 李端树, 胡超苏. Application of intensity-modulated radiotherapy in locoregionally advanced and recurrent poorly differentiated thyroid carcinoma[J]. China Oncology, 2018, 28(3): 216-221. DOI： 10.19401/j.cnki.1007-3639.2018.03.008.

摘要

背景与目的：甲状腺低分化癌（poorly differentiated thyroid carcinoma，PDTC）是一种罕见恶性肿瘤，易发生侵袭及转移，目前尚缺乏有效的治疗方法。本研究旨在分析调强放疗对局部晚期及复发PDTC的疗效及安全性。方法：纳入2011年2月—2014年9月在复旦大学附属肿瘤医院接受调强放疗的8例局部晚期及复发PDTC患者（均经病理及影像学确诊为T

4a-b

期PDTC）。1例术后无残留病灶但包膜侵犯的患者接受处方剂量60 Gy/30次的单纯放疗，其余患者甲状腺原发灶及淋巴结转移灶的处方剂量为66 Gy/33次，并接受顺铂为基础的联合化疗。结果：患者在放疗±化疗后，2例局部区域病灶完全缓解（complete response，CR），1例部分缓解（partial response，PR），5例保持疾病稳定（stable disease，SD）。截止末次随访或患者死亡时，局部区域控制率为87.5%（5例CR+1例PR+1例SD）。随访期间共有4例（50%）患者死亡，死亡原因分别为原发病灶进展（12.5%）和肺转移（37.5%）。大部分治疗相关不良反应为1~2级。结论：对于局部晚期及复发PDTC，调强放疗为基础的综合治疗能控制局部区域病灶，延长生存时间，不良反应可控，是一种有效且安全的治疗手段。

Abstract

Background and purpose: Poorly differentiated thyroid carcinoma (PDTC) is a rare malignant tumor with high rates of invasion and distant metastasis

and there is no effective treatment. This study aimed to investigate the efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) for locoregionally advanced and recurrent PDTC. Methods: From February 2011 to Sept

ember 2014

eight patients with biopsy-proven T

4a-b

PDTC who underwent IMRT at our center were enrolled. The prescribed dose was 60 Gy/30 F to high-risk areas for one patient with extracapsular invasion after radical surgery

and 66 Gy/33 F to primary lesion and positive lymph nodes for the rest patients who also received cisplatin-based chemotherapy. Results: After completion of treatment

2 patients had complete response (CR) to the locoregional disease

1 patient had partial response (PR) and 5 patients had stable disease (SD). By the last follow-up

the overall locoregional control rate was 87.5% (5 CR+1 PR+1 SD). Four patients (50%) finally died of locoregional disease progress (12.5%) and lung metastasis (37.5%). Most of the treatment-related toxicities were grade 1-2. Conclusion: IMRT-based therapy was effective and safe for locoregionally advanced and recurrent PDTC

with improved locoregional control and overall survival

as well as acceptable toxicities.

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