关键词: 甲状腺肿瘤；放化疗, 辅助；紫杉醇；生存曲线

Abstract: Objective　To evaluate the safety and efficacy of paclitaxel in the treatment of anaplastic thyroid carcinoma （ATC）.Methods　Thirty-two patients preliminarily diagnosed with ATC in the First Affiliated Hospital of Henan University of Science and Technology between April 2013 and March 2017 were selected.Twenty-one patients were confirmed with pathological examination.During the treatment，5 patients died from disease progression，and 2 patients withdrew treatment.Fourteen patients（9 females and 5 males） completed the entire treatment.The patients were administered paclitaxel （80 mg/m2），and each course lasted 3 weeks.The relative dose intensity and incidence of adverse reactions were analyzed.Adverse reaction events were recorded and graded on the basis of Common Terminology Criteria for Adverse Events v4.0.The overall survival（OS） of the patients was evaluated through follow-up，and the objective response rate was evaluated according to Response Evaluation Criteria In Solid Tumors.Results　The median number of courses completed was 10.The relative dose intensity of paclitaxel during the first two courses was more than 80.0%；there were no severe adverse reactions.Common adverse reactions included anemia（85.7%），leucopenia（71.4%），and hair loss（71.4%）.Six （42.9%） patients experienced adverse events grade 3 or above.The median OS of 14 ATC patients was 10.4 months，and the 6-month and 12-month survival rates were 85.7% and 42.9%，respectively.The 12-month survival rates of stage Ⅳa，Ⅳb，and Ⅳc patients were 80.0%，16.7%，and 0，respectively；Ⅳb and Ⅳc patients had poorer survival than did Ⅳa patients（χ2=7.627，10.317，P<0.001）.Three patients （21.4%） showed partial response，and 5 patients （35.7%） exhibited stable disease.Progressive disease （PD） occurred in 6 patients （42.9%）.The objective response rate was 21.4%.The progression time of the PD patients was 0.4-26.3 months，with a median time of 1.6 months.Four Ⅳa patients and 2 Ⅳb patients received postoperative radiotherapy，and their survival time was 15.5 months，which was significantly longer than the survival time （8.5 months） of those who did not receive radiotherapy（P=0.016）.Conclusion　Paclitaxel chemotherapy for the treatment of ATC can achieve a relatively high objective response rate and low incidence of adverse reactions.The treatment is effective and safe for ATC patients.

Key words: Thyroid neoplasms；Chemoradiotherapy, adjuvant；Paclitaxel；Survival curve