Abstract
BackgroundBrain metastasis from differentiated thyroid cancer has followed a similar increasing trend to that of thyroid cancer in recent years. However, the characteristics and treatments for brain metastases are unclear. The aim of this study was to understand this disease by analyzing patients with brain metastases from differentiated thyroid cancer (DTC).MethodsBetween 2000 and 2020, the database of the Sun Yat-sen University Cancer Center was searched for differentiated thyroid cancer patients. We identified a cohort of 22 patients with brain metastases. The characteristics of the patients, histological features, treatments, and time of death were reviewed. The overall survival (OS) rate was calculated using the Kaplan Meier method. Survival curves of different subgroups were compared according to baseline characteristics and treatments received.ResultsA total of 22 (1.09%) out of 2013 DTC patients in the Sun Yat-sen University Cancer Center database were identified as having brain metastases. The overall median survival time was 17.5 months (range from 1–60 months) after diagnosis of brain metastasis. Performance statue (PS), tumor site, and neurosurgery impacted survival, according to Kaplan-Meier analysis. Prognosis of skull metastasis was superior to that of intracranial types. Neurosurgery was the only type of treatment that had an impact on patient OS.ConclusionsBrain metastasis from differentiated thyroid cancer has a poor prognosis. However, it can be improved by comprehensive treatment. PS of the patients can greatly affect survival. Skull metastases have improved prognosis over intracranial types. Radioiodine therapy (RAIT) appears to effectively improve the prognosis of patients with skull metastases from DTC.
Highlights
Brain metastases (BMs) originating from differentiated thyroid cancer (DTC) are considered rare, occurring in approximately 1% of DTC [1, 2]
Twelve patients had histological confirmation that the brain lesions were of thyroid origin through biopsy or resection
We evaluated different type of therapeutic approaches(WBRT, RIT, chemotherapy, stereotactic radiosurgery (SRS), RT, neurosurgery) and found that SRS and neurosurgery have an impact on progression-free survival (PFS) (p
Summary
Brain metastases (BMs) originating from differentiated thyroid cancer (DTC) are considered rare, occurring in approximately 1% of DTC [1, 2]. Management of patients with BM of DTC origin is unclear, with questions remaining regarding indications for neurosurgery, external beam radiotherapy (EBRT), radioiodine therapy (RAIT), stereotactic radiosurgery (SRS), TKIs, or whole-brain RT (WBRT). There is evidence to show that disease-free and total survival is improved by RAIT in patients with lymph node and/or distant metastases [9, 10]. The prognostic benefit of RAIT is still inconclusive for patients with metastatic differentiated thyroid cancer; for those with brain metastases, RAIT seems to have an effect. The aim of this study was to understand this disease by analyzing patients with brain metastases from differentiated thyroid cancer (DTC)
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