Wu, Di1; Gomes Lima, Cristiane1; Moreau, Shari2; Kulkarni, Kanchan2; Zeymo, Alexander3; Burman, Kenneth4; Wartofsky, Leonard4; Van Nostrand, Douglas2
1 MedStar Health Research Institute, Washington D.C., USA
2 Division of Nuclear Medicine, Medstar Washington Hospital Center, Washington D.C., USA
3 Biostatistics, MedStar Health Research Institute, Hyattsville MD, USA
4 Division of Endocrinology, Medstar Washington Hospital Center, Washington D.C., USA
Background/Purpose: Until 2000, the 5-year overall survival (OS) rate of differentiated thyroid cancer (DTC) patients with bone metastases (BM) was reported at 7%-65%. The aim of this study was to determine the OS for DTC BM patients treated rigorously with multiple treatment modalities at MedStar Washington Hospital Center (MWHC), and to compare and review with literature.
Methods: A retrospective study was performed at MWHC from 2001-2017 of patients who had DTC, >1 I-131 therapy and BM. The following data were tabulated: age at DTC diagnosis, gender, histology, extent of disease, age at BM diagnosis, site(s) of BM, and additional treatment modalities (e.g. surgery, external beam radiation, radiofrequency ablation, cryotherapy, arterial embolization, antiresorptive agents, and tyrosine kinase inhibitors). Kaplan-Meier survival curve determined the 1-, 2-, 3-, 5-, and 10-year OS.
Results: Fifty-six patients met the inclusion criteria, the mean follow-up was 4.9 years (range, 0–23 years). Forty-three patients had I-131 treatment for BM; 31 external beam radiotherapy; 17 surgical excision; 7 Cyberknife®; 4 radiofrequency ablation; 1 cryotherapy; 2 arterial embolization; 11 tyrosine kinase inhibitor therapy; and 35 antiresorptive therapy. The 1, 2, 3, 5 and 10-year OS were 94%, 89%, 81%, 71% and 33%, respectively. The median OS is 6.5 years.
Conclusion: The 5-year and 10-year OS at MWHC is 71% and 33%, respectively, for DTC patients with BM, which are the highest reported OS in the literature to date. Further study is warranted to determine the clinical and treatment factors related to improved survival.