Year 2019, Volume 32, Issue 1, Pages 33 - 37 2019-01-29

A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer
Metastatik tiroid kanserinde sistemik tedavi etkinliğinin retrospektif olarak değerlendirilmesi

Atakan DEMİR [1]

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Objective: Thyroid cancer is the most common type of endocrine
cancer. The current approaches in the systemic therapies of
metastatic thyroid cancers are chemotherapy that is investigated in
phase II clinical trials and tyrosine kinase inhibitors, investigated
in phase III clinical trials. The aim of this study was to evaluate the
efficacy of systemic therapies in metastatic thyroid cancer patients.
Materials and Methods: We investigated 57 patients
retrospectively, diagnosed with thyroid cancer who were referred to
Maslak Acibadem Hospital Medical Oncology Department between
2008-2015 and Umraniye Training and Research Hospital between
2016-2018. They had received systemic treatment due to the refractory
profile to radioiodine therapy and metastatic thyroid cancer.
Results: Medical records of 57 patients with metastatic thyroid
cancer, who were referred for systemic therapy were retrospectively
analysed. 52% (n:30) of the cases were women and 48% (n:27)
were men, and the mean age was 57.11 years. All patients was
above the age of 18. Of the patients, 59.8% (n:35) had well
differentiated thyroid cancer, 29.8% (n:17) had medullary thyroid
cancer, 5.3% (n:3) had anaplastic thyroid cancer, 3.5% (n:2) had
poorly differentiated thyroid cancer and 1.8% (n:1) had medullarypapillary
synchronous cancer. When first line systemic therapy
was evaluated for all 57 patients, progression free survival (PFS)
was found 4.25 and 6.33 months for chemotherapy and sorafenib,
respectively (P:0.035). All cases were evaluated retrospectively
for second line systemic therapy and PFS was 4.1 and 7.77 months
for chemotherapy and sorafenib, respectively (P<0.001).
Conclusion: Tyrosine kinase inhibitors are used in the treatment
of radioactive iodine-refractory differentiated thyroid cancers and
medullary thyroid cancers. The effect of lenvatinib, sorafenib and
vandetanib on progression-free survival in thyroid cancers is found
to be superior to systemic chemotherapy. It was concluded that
sorafenib is a systemic treatment option which can be preferred in
terms of efficacy and toxicity profile in radioactive iodine refractory
well-differentiated thyroid cancer especially in our country.
Amaç: Tiroid kanserleri, endokrin kanserleri içerisinde en
sık görülen kanserdir. Metastatik tiroid kanserlerinin sistemik
tedavisinde güncel yaklaşımlar faz II çalışması olan kemoterapi
ve faz III çalışması tirozin kinaz inhibitörleridir. Çalışmamızda,
metastatic tiroid kanserli hastalarda sistemik tedavilerin etkinliğini
belirlemeyi hedefledik.
Gereçler ve Yöntemler : Maslak Acıbadem Hastanesi Tıbbi
Onkoloji Kliniği’ne 2008 ile 2015 yılları arasında ve 2016 ile 2018
yılları arasında Sağlık Bakanlığı Sağlık Bilimleri Üniversitesi
Ümraniye Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji
Kliniği’ne gelen ,hem metastaz gelişmesi, hem de radyoaktif iyot
tedavisine refrakter olması nedeniyle sistemik tedavi amacıyla
yönlendirilmiş olan 57 metastatik tiroid kanseri olan hastaların
dosyaları retrospektif olarak analiz edildi.
Bulgular : Hastaların, %52’si (30 hasta) kadın, %48’i (27
hasta) erkek, yaş ortalaması 57,11, ve tamamı 18 yaşın üzerinde
idi. Hastaların, %59,8’i (35 hasta) iyi diferansiye tiroid kanseri,
%29,8’i (17 hasta) medüller tiroid kanseri, %5,3’ü (3 hasta)
anaplastik tiroid kanseri, % 3,5’i ( 2 hasta) az diferansiye kanseri
ve %1,8’i ( 1 hasta) medüller-papiller senkron kanseri idi. Birinci
seri sistemik tedavi yanıtı tüm 57 olguda değerlendirildiğinde
progresyonsuz sağ kalım (PFS) süresi kemoterapi ve sorafenib için
sırasıyla 4,25 ve 6,33 ay olarak tespit edildi (P:0.035). İkinci seride
toplam 57 hasta dosyası retrospektif olarak değerlendirildi ve PFS,
kemoterapi alan ve sorafenib kullanılan hastalarda 4,1 ve 7,77 ay
olarak bulundu (P<0.001).
Sonuç: Radyoaktif iyot tedavisine refrakter olarak diferansiye
tiroid kanserleri ve medüller tiroid kanserleri tedavisinde tirozin
kinaz inhibitörü kullanılmaktadır. Tiroid kanserlerinde lenvatinib,
sorafenib ve vandetanibin progresyonsuz sağkalım üzerine olan
etkisi sistemik kemoterapiden üstün bulunmuştur. Özellikle,
ülkemizde olmak üzere radyoaktif iyod tedavisine refrakter iyi
diferansiye tiroid kanserlerinde sorafenib, etkinlik ve toksisite
profili açısından tercih edilebilecek bir sistemik tedavi seçeneğidir.
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Primary Language en
Subjects Medicine
Journal Section Articles
Authors

Author: Atakan DEMİR (Primary Author)

Bibtex @research article { marumj518826, journal = {Marmara Medical Journal}, issn = {1019-1941}, eissn = {1309-9469}, address = {Marmara University}, year = {2019}, volume = {32}, pages = {33 - 37}, doi = {10.5472/marumj.518826}, title = {A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer}, key = {cite}, author = {DEMİR, Atakan} }
APA DEMİR, A . (2019). A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer. Marmara Medical Journal, 32 (1), 33-37. DOI: 10.5472/marumj.518826
MLA DEMİR, A . "A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer". Marmara Medical Journal 32 (2019): 33-37 <http://dergipark.gov.tr/marumj/issue/42918/518826>
Chicago DEMİR, A . "A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer". Marmara Medical Journal 32 (2019): 33-37
RIS TY - JOUR T1 - A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer AU - Atakan DEMİR Y1 - 2019 PY - 2019 N1 - doi: 10.5472/marumj.518826 DO - 10.5472/marumj.518826 T2 - Marmara Medical Journal JF - Journal JO - JOR SP - 33 EP - 37 VL - 32 IS - 1 SN - 1019-1941-1309-9469 M3 - doi: 10.5472/marumj.518826 UR - https://doi.org/10.5472/marumj.518826 Y2 - 2018 ER -
EndNote %0 Marmara Medical Journal A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer %A Atakan DEMİR %T A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer %D 2019 %J Marmara Medical Journal %P 1019-1941-1309-9469 %V 32 %N 1 %R doi: 10.5472/marumj.518826 %U 10.5472/marumj.518826
ISNAD DEMİR, Atakan . "A retrospective analysis of efficacy of systemic therapy in metastatic thyroid cancer". Marmara Medical Journal 32 / 1 (January 2019): 33-37. https://doi.org/10.5472/marumj.518826