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KMID : 0356820180340010009
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Korean Journal of Head & Neck Oncology
2018 Volume.34 No. 1 p.9 ~ p.13
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Treatment Outcomes of Brain metastasis from Papillary Thyroid Cancer
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Bae Hyeon-Woo
Kim Seok-Mo
Chang Ho-JIn
Kim Bup-Woo
Lee Yong-Sang
Chang Hang-Seok
Park Cheong-Soo
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Abstract
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Background/Objectives: Brain metastasis (BM) is a rare form of distant metastasis with papillary thyroid cancer (PTC). Patients with BM of PTC carry a poor prognosis. The aim of this study was to contribute to the understanding of this disease by analyzing patients with BM of PTC.
Materials & Methods: Between March 2003 and December 2013, the patient database was conducted to identify thyroid cancer patients treated. Among the 22,758 thyroid cancer patients, 14 (0.06 %) were identified to have metastasis to the brain during follow-up. The medical records of 14 patients with BM were retrospectively reviewed, focusing on the following: patient characteristics, synchronous or previous distant metastasis, treatments including whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) and surgery, and characteristics on radiologic findings, time interval between first diagnosis of primary thyroid cancer and BM and survival after BM.
Results: The mean age at initial diagnosis and BM were 50.9 ± 15.8 years and 61.3 ± 12.7 years. The mean duration between initial diagnosis and BM was 10.4 ± 7.9 years. Patients were treated with varied combinations of surgery, SRS and WBRT except 4 patients who had refused treatment. The median overall survival (OS) time after BM diagnosis was 10 months (range 1 -19). Patients receiving treatment (WBRT and/or surgery, SRS) had a significant longer median OS of 16.5 months in comparison to 3.5 months for those treated without treatment. (p = 0.005)
Conclusion: Patients who received aggressive treatment had a longer OS than those with only supportive care. Treatment such as surgery, SRS and WBRT should be considered in patients with BM.
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KEYWORD
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Brain metastasis, Thyroid cancer, Surgery, Radiotherapy, Survival
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