@phdthesis{oai:nagasaki-u.repo.nii.ac.jp:00026540,
 author = {中嶋, 遥美},
 month = {Mar},
 note = {Background: Lenvatinib is one of the few therapeutic options available for radioiodine-refractory thyroid cancer. However, the factors that determine the therapeutic outcomes remain unknown.
Methods: Patients with thyroid carcinoma treated with lenvatinib who had been dead or who had survived for longer than a halfyear were retrospectively compared. We evaluated the clinical parameters when lenvatinib was started, and also studied the tumor volume reduction ratio, the duration until re-growth of the largest metastatic lesion, the thyroglobulin (Tg) reduction rate, and the duration until re-elevation of Tg after lenvatinib between survivors and dead patients.
Results: We identified 16 patients, with an average age of 73.1±7.6 yrs and a male-to-female ratio of 5 to 11, who had advanced differentiated thyroid cancer that was treated with lenvatinib. Nine patients had died after 8.9±6.1 months, whereas 7 survived for 13.0±2.0 months after starting lenvatinib. The patients who died were older than the survivors (76.7±6.5 vs. 68.6±6.6 yrs, p=0.03). Malignant pleural effusion (p=0.017) and symptomatic metastatic disease (SMD) (p=0.039) were associated with death in a Kaplan-Meier survival analysis. Age (p=0.012, HR 1.150, CI 1.030-1.320) and SMD (p=0.014, HR 8.069, CI 1.503-61.34) were associated with poor outcome in a multivariate Cox proportional hazard model. The duration until the re-elevation of Tg was longer in survivors than in patients who died (6.43±4.55 vs. 2.17±1.39 months, p=0.025).
Conclusions: We identified multiple factors, including SMD, that were related to poor outcomes after lenvatinib treatment. This study suggests that lenvatinib might be started before patients develop SMD., 長崎大学学位論文 学位記番号:共博(医歯薬)甲第9号 学位授与年月日:令和3年3月22日, Author: Yomi Nakashima, Takao Ando, Aya Nozaki, Ayako Ito, Ichiro Horie, 
Misa Imaizumi, Toshiro Usa and Atsushi Kawakami, Acta Medica Nagasakiensia, 63, pp.71−77; 2020, Nagasaki University (長崎大学), 博士(医学) (2021-03-22)},
 school = {Nagasaki University (長崎大学)},
 title = {Age, Symptomatic Metastatic Disease, and Malignant Pleural Effusion as Predictors of Poor Prognosis in Patients with Differentiated Thyroid Carcinoma Treated with Lenvatinib.},
 year = {2021}
}