The Largest Known Survival Analysis of Patients with Brain Metastasis from Thyroid Cancer Based on Prognostic Groups.
The Largest Known Survival Analysis of Patients with Brain Metastasis from Thyroid Cancer Based on Prognostic Groups.
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DOI：
10.1371/journal.pone.0154739
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Lee IJ
中科院分区：
文献类型：
--
作者：
Choi J;Kim JW;Keum YS;Lee IJ
分析分化型甲状腺癌（DTC）罕见脑转移（BM）患者的临床特征及影响生存的预后因素。共纳入了1995年至2014年间诊断为BM的37例DTC患者。我们回顾了BM的临床特征、治疗方式和影像学表现。评估与生存相关的因素，并将患者分为三个预后组（A，B和C组）进行比较分析。BM时的中位年龄为63岁，从最初甲状腺癌诊断到BM的中位时间为3.8年。BM后的中位生存期和1年精算生存率分别为8.8个月和47%。根据单因素和多因素分析，确定了4个良好预后因素（GPFs），包括年龄≤ 60岁，PS ≤ ECOG 2，BM部位≤ 3个，BM前无颅外转移。根据年龄和剩余GPF数设计3个预后组：≤ 60岁且至少有2个GPF的患者（A组）预后最好，中位生存期为32.8个月; ≤ 60岁且少于2个GPF的患者和> 60岁且至少有2个GPF的患者（B组）中位生存期为9.4个月;年龄> 60岁且少于2个GPF的患者（C组）预后最差，中位生存期为1.5个月。根据良好预后因素的总数，BM形成DTC患者的生存率在预后组之间存在差异。
To analyze the clinical features and prognostic factors associated with the survival of patients with a very rare occurrence of brain metastasis (BM) from differentiated thyroid cancer (DTC). A total of 37 patients with DTC who were diagnosed with BM between 1995 and 2014 were included. We reviewed the clinical characteristics, treatment modalities, and image findings of BM. Factors associated with survival were evaluated, and the patients were divided into three prognostic groups (Groups A, B, and C) for comparative analysis. The median age at BM was 63 years, and the median time from initial thyroid cancer diagnosis to BM was 3.8 years. The median survival and the 1-year actuarial survival rate after BM were 8.8 months and 47%, respectively. According to univariate and multivariate analyses, four good prognostic factors (GPFs) were identified including age ≤ 60 years, PS ≤ ECOG 2, ≤ 3 BM sites, and without extracranial metastasis prior to BM. Three prognostic groups were designed based on age and number of remaining GPFs: patients ≤ 60 years of age with at least 2 GPFs (Group A) had the most favorable prognosis with a median survival of 32.8 months; patients ≤ 60 years of age with fewer than 2 GPFs and those > 60 years of age with at least 2 GPFs (Group B) had an intermediate prognosis with a median survival of 9.4 months; and patients > 60 years of age with fewer than 2 GPFs (Group C) had the least favorable prognosis with a median survival of 1.5 months. The survival of patients with BM form DTC differed among the prognostic groups based on the total number of good prognostic factors.