Application value of multidisciplinary team in diagnosis and treatment of advance special thyroid cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUAN Xiaoqing ¹ ,  ZHENG Xiangxin ¹ , GU Shucheng ¹ , YUAN Mu ¹ , WU Ji ¹ , JIANG Xiaoling ² , SHI Xiaohong ² , NIU Lei ³ , ZHENG Zhongfeng ⁴ , LU Xiyan ⁵

1. Department of Thyroid & Breast Surgery, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P. R. China;
2. Department of Pathology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P. R. China;
3. Department of Imaging Division, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P. R. China;
4. Department of Thoracic Surgery, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P. R. China;
5. Department of Oncology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P. R. China;

Corresponding?author：

ZHENG Xiangxin, Email: zhengxiangxin_dr@163.com

Keywords：

thyroid cancer; advance; special type; apatinib; low dose; single drug

DOI：

10.7507/1007-9424.201806027

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore value of multidisciplinary team (MDT) model in diagnosis and treatment of patients with advanced special thyroid cancer who lost chance of operation. Method Two patients with the advanced special thyroid cancer who lost chance of operation were treated by low dose apatinib (250 mg/d) after the MDT discussion. Results One medullary thyroid cancer patient with the compressing of the trachea for mediastinal metastatic lymphadenopathy and inability to lie down underwent the multiple surgical treatment, the therapeutic effect was poor. Then low dose apatinib (250 mg/d) was performed, the patient could supine, breathe smoothly, and move freely, whose life quality was obviously improved, the mediastinal lymph nodes reduced and no serious drug toxicity occurred on month 1 after the treatment. One undifferentiated thyroid cancer patient with the lung metastasis, hemoptysis, and tumor invasion resulted in the inability to lie down and having difficulty in breathing, these symptoms still existed and more pleural effusion occurred after the resection of the invaded trachea. Then low dose apatinib (250 mg/d) was performed, the patient could supine, the pleural effusion disappeared, the hemoptysis stopped, the breathing was smooth, and could do some minor housework, no drug toxicity occurred on month 1 after the treatment. Conclusion After MDT discussion, low dose apatinib in treatment of advanced special thyroid cancer is reliable and safe and has a good short-term effect, which could be used as a new remedy, but long-term effect should be further researched by increasing case samples and a long-term following-up.

Citation： GUAN Xiaoqing, ZHENG Xiangxin, GU Shucheng, YUAN Mu, WU Ji, JIANG Xiaoling, SHI Xiaohong, NIU Lei, ZHENG Zhongfeng, LU Xiyan. Application value of multidisciplinary team in diagnosis and treatment of advance special thyroid cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(9): 1115-1120. doi: 10.7507/1007-9424.201806027 Copy

1.	中國臨床腫瘤學會抗腫瘤藥物安全管理專家委員會. 阿帕替尼治療胃癌的臨床應用專家共識. 臨床腫瘤學雜志, 2015, 20(9): 841-847.
2.	丁林, 江志敏, 李懷. 晚期非小細胞肺癌抗血管生成治療: 文獻復習及病例報道. 嶺南現代臨床外科, 2015, 15(6): 656-660.
3.	Fontanella C, Ongaro E, Bolzonello S, et al. Clinical advances in the development of novel VEGFR2 inhibitors. Ann Transl Med, 2014, 2(12): 123.
4.	涂艷, 彭楓. 阿帕替尼治療惡性腫瘤的臨床研究進展. 中國腫瘤臨床, 2016, 43(12): 545-548.
5.	林巖松, 王宸, 李慧, 等. 甲磺酸阿帕替尼治療進展性碘難治性甲狀腺癌的短期療效的安全性初步報告. 中國癌癥雜志, 2016, 26(9): 721-726.
6.	叢慧, 梁軍, 林巖松. 碘難治性分化型甲狀腺癌的診斷與靶向治療. 國際放射醫學核醫學雜志, 2015, 39(1): 25-31.
7.	張鑫, 王宸, 梁軍, 等. 進展性碘難治性分化型甲狀腺癌患者阿帕替尼治療后血清學與影像學指標變化. 中國腫瘤臨床, 2017, 44(8): 371-376.
8.	林巖松, 楊雪. RAIR-DTC的診治進展. 中國癌癥雜志, 2017, 27(6): 442-450.
9.	鄢丹桂, 張彬, 李正江, 等. 甲狀腺髓樣癌頸部淋巴轉移規律的臨床研究. 中華耳鼻咽喉頭頸外科雜志, 2015, 50(4): 290-294.
10.	Moley JF. Medullary thyroid carcinoma: management of lymph node metastases. J Natl Compr Canc Netw, 2010, 8(5): 549-556.
11.	高云飛, 鄧維葉, 陳艷峰, 等. 甲狀腺髓樣癌預后相關因素分析(附 118 例報告). 中國實用外科雜志, 2015, 35(9): 996-1000.
12.	董薇, 陳曉紅. 甲狀腺髓樣癌研究進展. 國際耳鼻咽喉頭頸外科雜志, 2013, 37(1): 42-46.
13.	蔣堯瀛, 姜成威, 王喆輝, 等. 甲狀腺未分化癌 5 例臨床病理特征分析. 臨床與實驗病理學雜志, 2016, 32(11): 1281-1283.
14.	孫濱, 郭伯敏, 康杰, 等. 甲狀腺未分化癌的規范化治療. 山東大學耳鼻喉眼學報, 2017, 31(6): 16-20.
15.	Anderson RT, Linnehan JE, Tongbram V, et al. Clinical, safety, and economic evidence in radioactive iodine-refractory differentiated thyroid cancer: a systematic literature review. Thyroid, 2013, 23(4): 392-407.
16.	代文杰, 朱化強. 甲狀腺癌的分子靶向治療. 中國實用外科雜志, 2011, 31(5): 456-458.
17.	Schlumberger M, Brose M, Elisei R, et al. Definition and management of radioactive iodine-refractory differentiated thyroid cancer. Lancet Diabetes Endocrinol, 2014, 2(5): 356-358.
18.	Gild ML, Bullock M, Robinson BG, et al. Multikinase inhibitors: a new option for the treatment of thyroid cancer. Nat Rev Endocrinol, 2011, 7(10): 617-624.
19.	劉澤明, 李大鵬, 黃韜. 甲狀腺癌分子靶向治療的現狀和前景展望. 中國現代普通外科進展, 2013, 16(1): 43-46.
20.	Perez CA, Santos ES, Arango BA, et al. Novel molecular targeted therapies for refractory thyroid cancer. Head Neck, 2012, 34(5): 736-745.
21.	高明. 國內分化型甲狀腺癌診療方向和對策. 中國實用外科雜志, 2011, 31(5): 376-379.
22.	王波, 趙文新. 甲狀腺癌靶向治療進展. 中國實用外科雜志, 2015, 35(6): 674-678.
23.	安常明, 王錚, 韓志楷, 等. 索拉非尼聯合脂質體阿霉素治療甲狀腺低分化癌裸鼠移植瘤的療效觀察. 中華耳鼻咽喉頭頸外科雜志, 2012, 47(11): 931-936.
24.	Gule MK, Chen Y, Sano D, et al. Targeted therapy of VEGFR2 and EGFR significantly inhibits growth of anaplastic thyroid cancer in an orthotopic murine model. Clin Cancer Res, 2011, 17(8): 2281-2291.
25.	Grosse J, Warnke E, Wehland M, et al. Mechanisms of apoptosis in irradiated and sunitinib-treated follicular thyroid cancer cells. Apoptosis, 2014, 19(3): 480-490.
26.	Di Desidero T, Fioravanti A, Orlandi P, et al. Antiproliferative and proapoptotic activity of sunitinib on endothelial and anaplastic thyroid cancer cells via inhibition of Akt and ERK1/2 phosphorylation and by down-regulation of cyclin-D1. J Clin Endocrinol Metab, 2013, 98(9): E1465-E1473.
27.	Fenton MS, Marion KM, Salem AK, et al. Sunitinib inhibits MEK/ERK and SAPK/JNK pathways and increases sodium/iodide symporter expression in papillary thyroid cancer. Thyroid, 2010, 20(9): 965-974.
28.	Mologni L, Redaelli S, Morandi A, et al. Ponatinib is a potent inhibitor of wild-type and drug-resistant gatekeeper mutant RET kinase. Mol Cell Endocrinol, 2013, 377(1-2): 1-6.
29.	龔艷萍, 劉楓, 鄒秀和, 等. 甲狀腺髓樣癌的診治進展. 中國普外基礎與臨床雜志, 2016, 23(5): 620-625.
30.	Cohen EE, Tortorici M, Kim S, et al. A phase Ⅱ trial of axitinib in patients with various histologic subtypes of advanced thyroid cancer: long-term outcomes and pharmacokinetic/pharmacodynamic analyses. Cancer Chemother Pharmacol, 2014, 74(6): 1261-1270.
31.	Díez JJ, Iglesias P, Alonso T, et al. Activity and safety of sunitinib inpatients with advanced radioactive iodine-refractory differentiated thyroid carcinoma in clinical practice. Endocrine, 2015, 48(2): 582-588.
32.	Bible KC, Suman VJ, Molina JR, et al. Efficacy of pazopanib in progressive, radioiodine-refractory, metastatic differentiated thyroid cancers: results of a phase 2 consortium study. Lancet Oncol, 2010, 11(10): 962-972.
33.	Longo R, Gasparini G. Challenges for patient selection with VEGF inhibitors. Cancer Chemother Pharmacol, 2007, 60(2): 151-170.
34.	徐德全, 代文杰. 甲狀腺髓樣癌的靶向治療. 中國普外基礎與臨床雜志, 2014, 21(12): 1579-1582.
35.	曹邦偉, 趙鵬飛. 阿帕替尼治療胃癌及其他腫瘤的研究現狀. 臨床與病理雜志, 2016, 36(6): 815-823.
36.	Li J, Qin S, Xu J, et al. A randomized, double-blind, multicenter, phase Ⅱ, three-arm, placebo-control study of apatinib as third-line treatment in patients with metastatic gastric carcinoma. J Clin Oncol, 2011, 29(Suppl): Abstr4019.
37.	Li J, Qin S, Xu J, et al. Apatinib for chemotherapy-refractory advanced metastatic gastric cancer: results from a randomized, placebo-controlled, parallel-arm, phase Ⅱ trial. J Clin Oncol, 2013, 31(26): 3219-3225.
38.	Qin S. Phase Ⅲ study of apatinib in advanced gastric cancer: A randomized, double-blind, placebo-controlled trial. J Clin Oncol, 2014, 32(Suppl): Abst4003.

1. 中國臨床腫瘤學會抗腫瘤藥物安全管理專家委員會. 阿帕替尼治療胃癌的臨床應用專家共識. 臨床腫瘤學雜志, 2015, 20(9): 841-847.
2. 丁林, 江志敏, 李懷. 晚期非小細胞肺癌抗血管生成治療: 文獻復習及病例報道. 嶺南現代臨床外科, 2015, 15(6): 656-660.
3. Fontanella C, Ongaro E, Bolzonello S, et al. Clinical advances in the development of novel VEGFR2 inhibitors. Ann Transl Med, 2014, 2(12): 123.
4. 涂艷, 彭楓. 阿帕替尼治療惡性腫瘤的臨床研究進展. 中國腫瘤臨床, 2016, 43(12): 545-548.
5. 林巖松, 王宸, 李慧, 等. 甲磺酸阿帕替尼治療進展性碘難治性甲狀腺癌的短期療效的安全性初步報告. 中國癌癥雜志, 2016, 26(9): 721-726.
6. 叢慧, 梁軍, 林巖松. 碘難治性分化型甲狀腺癌的診斷與靶向治療. 國際放射醫學核醫學雜志, 2015, 39(1): 25-31.
7. 張鑫, 王宸, 梁軍, 等. 進展性碘難治性分化型甲狀腺癌患者阿帕替尼治療后血清學與影像學指標變化. 中國腫瘤臨床, 2017, 44(8): 371-376.
8. 林巖松, 楊雪. RAIR-DTC的診治進展. 中國癌癥雜志, 2017, 27(6): 442-450.
9. 鄢丹桂, 張彬, 李正江, 等. 甲狀腺髓樣癌頸部淋巴轉移規律的臨床研究. 中華耳鼻咽喉頭頸外科雜志, 2015, 50(4): 290-294.
10. Moley JF. Medullary thyroid carcinoma: management of lymph node metastases. J Natl Compr Canc Netw, 2010, 8(5): 549-556.
11. 高云飛, 鄧維葉, 陳艷峰, 等. 甲狀腺髓樣癌預后相關因素分析(附 118 例報告). 中國實用外科雜志, 2015, 35(9): 996-1000.
12. 董薇, 陳曉紅. 甲狀腺髓樣癌研究進展. 國際耳鼻咽喉頭頸外科雜志, 2013, 37(1): 42-46.
13. 蔣堯瀛, 姜成威, 王喆輝, 等. 甲狀腺未分化癌 5 例臨床病理特征分析. 臨床與實驗病理學雜志, 2016, 32(11): 1281-1283.
14. 孫濱, 郭伯敏, 康杰, 等. 甲狀腺未分化癌的規范化治療. 山東大學耳鼻喉眼學報, 2017, 31(6): 16-20.
15. Anderson RT, Linnehan JE, Tongbram V, et al. Clinical, safety, and economic evidence in radioactive iodine-refractory differentiated thyroid cancer: a systematic literature review. Thyroid, 2013, 23(4): 392-407.
16. 代文杰, 朱化強. 甲狀腺癌的分子靶向治療. 中國實用外科雜志, 2011, 31(5): 456-458.
17. Schlumberger M, Brose M, Elisei R, et al. Definition and management of radioactive iodine-refractory differentiated thyroid cancer. Lancet Diabetes Endocrinol, 2014, 2(5): 356-358.
18. Gild ML, Bullock M, Robinson BG, et al. Multikinase inhibitors: a new option for the treatment of thyroid cancer. Nat Rev Endocrinol, 2011, 7(10): 617-624.
19. 劉澤明, 李大鵬, 黃韜. 甲狀腺癌分子靶向治療的現狀和前景展望. 中國現代普通外科進展, 2013, 16(1): 43-46.
20. Perez CA, Santos ES, Arango BA, et al. Novel molecular targeted therapies for refractory thyroid cancer. Head Neck, 2012, 34(5): 736-745.
21. 高明. 國內分化型甲狀腺癌診療方向和對策. 中國實用外科雜志, 2011, 31(5): 376-379.
22. 王波, 趙文新. 甲狀腺癌靶向治療進展. 中國實用外科雜志, 2015, 35(6): 674-678.
23. 安常明, 王錚, 韓志楷, 等. 索拉非尼聯合脂質體阿霉素治療甲狀腺低分化癌裸鼠移植瘤的療效觀察. 中華耳鼻咽喉頭頸外科雜志, 2012, 47(11): 931-936.
24. Gule MK, Chen Y, Sano D, et al. Targeted therapy of VEGFR2 and EGFR significantly inhibits growth of anaplastic thyroid cancer in an orthotopic murine model. Clin Cancer Res, 2011, 17(8): 2281-2291.
25. Grosse J, Warnke E, Wehland M, et al. Mechanisms of apoptosis in irradiated and sunitinib-treated follicular thyroid cancer cells. Apoptosis, 2014, 19(3): 480-490.
26. Di Desidero T, Fioravanti A, Orlandi P, et al. Antiproliferative and proapoptotic activity of sunitinib on endothelial and anaplastic thyroid cancer cells via inhibition of Akt and ERK1/2 phosphorylation and by down-regulation of cyclin-D1. J Clin Endocrinol Metab, 2013, 98(9): E1465-E1473.
27. Fenton MS, Marion KM, Salem AK, et al. Sunitinib inhibits MEK/ERK and SAPK/JNK pathways and increases sodium/iodide symporter expression in papillary thyroid cancer. Thyroid, 2010, 20(9): 965-974.
28. Mologni L, Redaelli S, Morandi A, et al. Ponatinib is a potent inhibitor of wild-type and drug-resistant gatekeeper mutant RET kinase. Mol Cell Endocrinol, 2013, 377(1-2): 1-6.
29. 龔艷萍, 劉楓, 鄒秀和, 等. 甲狀腺髓樣癌的診治進展. 中國普外基礎與臨床雜志, 2016, 23(5): 620-625.
30. Cohen EE, Tortorici M, Kim S, et al. A phase Ⅱ trial of axitinib in patients with various histologic subtypes of advanced thyroid cancer: long-term outcomes and pharmacokinetic/pharmacodynamic analyses. Cancer Chemother Pharmacol, 2014, 74(6): 1261-1270.
31. Díez JJ, Iglesias P, Alonso T, et al. Activity and safety of sunitinib inpatients with advanced radioactive iodine-refractory differentiated thyroid carcinoma in clinical practice. Endocrine, 2015, 48(2): 582-588.
32. Bible KC, Suman VJ, Molina JR, et al. Efficacy of pazopanib in progressive, radioiodine-refractory, metastatic differentiated thyroid cancers: results of a phase 2 consortium study. Lancet Oncol, 2010, 11(10): 962-972.
33. Longo R, Gasparini G. Challenges for patient selection with VEGF inhibitors. Cancer Chemother Pharmacol, 2007, 60(2): 151-170.
34. 徐德全, 代文杰. 甲狀腺髓樣癌的靶向治療. 中國普外基礎與臨床雜志, 2014, 21(12): 1579-1582.
35. 曹邦偉, 趙鵬飛. 阿帕替尼治療胃癌及其他腫瘤的研究現狀. 臨床與病理雜志, 2016, 36(6): 815-823.
36. Li J, Qin S, Xu J, et al. A randomized, double-blind, multicenter, phase Ⅱ, three-arm, placebo-control study of apatinib as third-line treatment in patients with metastatic gastric carcinoma. J Clin Oncol, 2011, 29(Suppl): Abstr4019.
37. Li J, Qin S, Xu J, et al. Apatinib for chemotherapy-refractory advanced metastatic gastric cancer: results from a randomized, placebo-controlled, parallel-arm, phase Ⅱ trial. J Clin Oncol, 2013, 31(26): 3219-3225.
38. Qin S. Phase Ⅲ study of apatinib in advanced gastric cancer: A randomized, double-blind, placebo-controlled trial. J Clin Oncol, 2014, 32(Suppl): Abst4003.

Previous Article
Reoperation of a patient with type Ⅳa congenital choledochal cyst
Next Article
4種解剖標志幫助識別膽囊管避免膽管損傷（附316例報道）

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application value of multidisciplinary team in diagnosis and treatment of advance special thyroid cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content