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    Home > Active Ingredient News > Endocrine System > "The Mildest Cancer" hides the power of evil, and research has proved that nothing can be said!

    "The Mildest Cancer" hides the power of evil, and research has proved that nothing can be said!

    • Last Update: 2020-09-01
    • Source: Internet
    • Author: User
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    Thyroid cancer is the most common endocrine malignant tumor of all cancers.
    Thyroid cancer can be divided into differentiated types (including papilloblastoma and follicular thyroid cancer, DTC), low differentiation (PDTC) and undifferentiated (ATC) according to the pathological tissue type of thyroid cancer.
    It is well known that thyroid cancer is often referred to as the "mildest cancer" because DTC-based thyroid cancer has a better prognosis, slow progression and a high 10-year survival rate, but some histological substations are prone to thyroid aggression, vascular invasion and distant metastasis, with a high recurrence rate and a relatively poor prognosis.
    ATC is one of the most invasive and lethal solid tumors.
    U.S. End Results Database Analysis (1986-2015) ATC reported a total survival (OS) of 4 months, 35% of 6 months of OS, and a disease-specific mortality rate of 98% to 99%.
    unlike DTCs, which have a good prognosis and are surgery-based, ATC patients typically experience rapid growth, indistinated neck lumps, localized neck lymph nodes, and about half of patients with distant metastatic diseases.
    as a result, ATC patients are generally inconsericated and have been placed in palliative care or referred to hospice care.
    ATC accounts for less than 2% of thyroid cancer, it is estimated that more than 50% of thyroid cancer-related deaths each year are caused by it.
    , however, the link between the atHC's major progress in treatment and OS in recent years has yet to be assessed.
    August 6, JAMA published an online report, "Evaluation of Total in Patients with Anaplastic Thyroid Carcinoma, 2000-2019", which assessed the rate of OS in ATC patients over the past 20 years.
    large single-agency queue study, which spanned nearly 20 years, changes in patient management appeared to be associated with significant improvements in survival rates.
    with the integration of multidisciplinary treatments such as surgery and radiotherapy, personalized, molecular-based therapy is gradually replacing the insoeverable ATC era.
    Multimodal Therapy Retrospective Assessment of PATIENTs with PATH who attended and pathologically confirmed at the University of Texas Anderson Cancer Center from January 2000 to October 2019, collected the patient's demographic characteristics, age-proofed Charson's consonation index, and BRAF V600E molecular detection and treatment methods (cytotoxic chemotherapy, targeted therapy, immunotherapy, surgery, and treatment) data for radiotherapy, and divided patients into three subgroups based on the date of visit: January 2000-December 2013, January 2014-December 2016, January 2017-October 2019, the choice of group year is based on changes in treatment patterns in cancer centres, as detailed in Figures A and B.
    (BRAFi for BRAF inhibitors; cfDNA for cell-free DNA; CTx for cytotoxic chemotherapy; EBRT for insoular radiotherapy; IHC for immunohydrotective chemistry; MEKi for MEK inhibitors) A: IVA stage surgery plus EBRT plus CTx.
    receive new complementary BRAFi/MEKi-/-immunotherapy during the IVB/IVC phase.
    if the tumor can be removed, surgery can be performed within 3 months of the new auxiliary BRAFi/MEKi.
    ivB postoperative line EBRT-CTx treatment.
    BRAFi/MEKi immunotherapy is suspended during radiation (there is a risk of radiation recall) and resumes after radiation.
    reboot braFi/MEKi-/-immunotherapy after the IVC phase and do not provide EBRT (drug retention during radiotherapy may lead to progression of distant metastasis).
    B:IVA/IVB stage tumor can be removed and then undergo surgery with the operation of EBRT plus CTx.
    accept EBRT-CTx for non-excisible IVB periods.
    long-term metastatic lesions that can be removed by combining the IVC phase require surgical treatment.
    patients with low volume that cannot be removed receive palliative radiotherapy and then systemic treatment.
    patients with large volumes that cannot be removed receive systemic treatment.
    received stereotactic radiation therapy for less progressional lesions in a mixed IVC phase.
    care is provided if treatment is not tolerated.
    479 patients who were effective in improving OS inclusion in the three treatments, 246 were men (51%), 233 were women (49%), with a middle age of 65.0 years and an age range of 2 1.1 to 92.6 years old, of which 52 cases (11%) were IVA period, 172 cases (36%) were IVB period and 255 cases (53%) were IVC period.
    2000-2013, the medium OS was 0.67 years, the 2014-2016 mid-term OS was 0.88, and the 2017-2019 mid-OS was 1.31 years.
    OS for the entire queue was 0.79 years (9.5 months) and ranged from 0.01 to 16.63.
    associated with OS improvements include targeted therapy, immunotherapy in targeted therapy, and surgery following new assisted BRAF-guided treatments.
    Figure 1 Baseline characteristic targeted therapy in three groups of patients: Over time, the use of targeted therapy increased significantly, which was associated with median OS improvement (1.31 years for patients receiving targeted therapy, compared to 0.63 years for patients who did not receive targeted therapy, with a risk ratio of 0.49).
    immunotherapy in targeted therapy: Immunotherapy use also increased significantly in the 2017-2019 group (47%) compared to the 2000-2013 (1%) and 2014-2016 (18%).
    For patients in 2014-2019, patients who received immunotherapy targeted treatment (76 cases) and patients who received targeted treatment without immunotherapy (59 cases) had significantly increased OS (1.99 years (23.9 months) vs 1.20 years (14.4 months), which means an increase in survival rate of 0.79 years (9.5 months).
    new assisted BRAF-guided post-treatment surgery: New preoperative assisted BRAF-guided treatment (implemented only in 2017-2019) is also associated with increased survival rates.
    compared whether patients treated under BRAF guidance received surgery, the previous group's mid-OS did not reach (an average of 1.21 years of follow-up), while the 2nd group's mid-OS was 0.80 years (risk ratio was 0.29).
    2 Evidence-based data on two-year OS (by year of onset) of ATC patients has led to new directions of treatment recently, with several major centers reporting decades of experience in selecting ATC treatment options, especially those who are able to undergo surgery and routine chemotherapy. The
    Mayo Clinic reported results for 48 patients with multiple-mode ATC treatment over a 13-year period (2003-2015), including surgery, yew-based chemotherapy and radiotherapy, with a reported OS of 9 months and 42% of one-year OS.
    Portuguese Institute of Oncology reported that of the 79 ATC patients over 18 years (2000-2018), the average survival period was 2 months, with patients receiving single or multi-mode therapy, including surgery, radiotherapy and chemotherapy.
    similar treatment, Duke University reported an average survival of 4 months and an 18 percent one-year survival rate in 28 patients over a 25-year period (1990-2015).
    Memorial Sloan-Kettering Cancer Center recently released retrospective data on a group of 104 ATC patients who received radiation therapy (1984-2017) who received simultaneous chemotherapy (based on amycin or yew alcohol) or surgery and synchronous chemotherapy over a 33-year period (1984-2017).
    the memorial Sloan-Kettering center had a mid-life of 7 months, with a one-year survival rate of 34 percent, compared with a 55 percent one-year survival rate for patients who had selective surgery and simultaneous postoperative chemotherapy (n-53).
    study, although the increase in survival rates cannot be directly attributed to immunotherapy due to a variety of mixed factors, especially when targeted therapy is used at the same time.
    While single-drug immunotherapy does not show great prospects for the treatment of ATC, ongoing and/or completed clinical trials are studying the potential of combining immunotherapy agents such as pembrolizumab and atazolizumab with targeted therapy, with significant results to date.
    The rationale for increasing immunotherapy is that all patients eventually develop resistance to kinase inhibitor targeted therapy, immunotherapy may delay and/or prevent the emergence of drug resistance variants, and provide the ability to maintain targeted treatment when needed (e.g. due to toxicity, during surgery, during radiotherapy) in order to maintain disease control.
    the combined study found that in the past five years, ATC treatments have evolved from initial palliative care and hospice care to effective, highly specialized, highly specialized, personalized, molecular-based therapies and appropriate surgical procedures, regardless of the stage of the disease.
    Tao Ran Source: Health !-- End of Content Presentation -- !-- Determine whether or not to log in to end.
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