Objective To evaluate the efficacy of anlotinib in treatment of progressive iodine-refractory differentiated thyroid cancer(RAIR-DTC)and its effect on patient's survival time.Methods Conducting a prospective study,we selected 82 patients with RAIR-DTC treated with anlotinib in Gansu Provincial Tumor Hospital between January 2018 and December 2023 for the observation group.Another 78 patients with progressive RAIR-DTC receiving sorafenib during the identical period were enrolled for the control group.A follow-up investigation was conducted on the patients(follow-up until December 2023).After 3,6 and 16 weeks of treatment,the serum thyroglobulin(Tg)decline rate was compared between the two groups.The volume reduction rates of target lesions in the two groups of patients were compared for 6 months and 12 months of follow-up,and Kaplan-Meier was used to compare the progression-free survival and overall survival between the two groups.Results Following treatment,the overall response rate(ORR)in the observation group was notably higher(89.02%)as compared with the control(74.36%)(χ2=5.794,P<0.05).Both the Tg levels and target lesions in the observation were found to be significantly elevated as compared with those in the control(74.36%).The volume measurements((44.25±5.31)μg·L-1,(93.63±28.35)mm3,(42.00±5.82)μg·L-1,(132.78±27.72)mm3)decreased substantially from pretreatment values((151.87±25.21)μg·L-1,(702.94±105.64)mm3,(152.62±25.62)μg·L-1,(703.26±106.84)mm3)(t=37.827,50.445,t=37.186,45.647,all P<0.05).There was no notable difference in the decline rate of serum Tg between the two groups(t=1.616,P>0.05).Moreover,6 months after treatment,there was no significant variance in the volume reduction rate of target lesions between the two groups(t=1.272,P>0.05).After 12 months of treatment,the observation group exhibited a significantly higher reduction rate of target lesion volumes as compared with the control(t=1.661,P<0.05).The 1-year overall survival rate showed no statistically significant difference between the observation group(98.78%)and the control(98.72%)(χ2=0.001,P>0.05).Similarly,the median progression-free survival time and overall survival time did not significantly differ between the two groups(21 months,34 months vs 22 months,36 months,χ2=0.748,0.001,both P>0.05).In terms of adverse reactions,the observation group experienced a significantly lower incidence(56.10%)than the control(77.79%)(χ2=4.262,P<0.05).Meanwhile,the observation group had lower rates of hand and foot skin reactions(12.20%),diarrhea(12.20%)and fatigue(12.20%)as compared with the control(26.92%,29.49%,26.92%)(χ2=5.551,7.301,7.301,all P<0.05).Conclusion Anlotinib has significant efficacy and safety in treatment of patients with RAIR-DTC and can be used as a new treatment option for these patients.
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