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

摘要： 目的  评估紫杉醇治疗甲状腺未分化癌（ATC）的安全性和有效性。方法　选取2013年4月—2017年3月河南科技大学第一附属医院收治的32例初步诊断为ATC的患者。21例经病理检查确诊，治疗过程中由于病变进展（PD）5例患者死亡、2例患者中途退出，最终14例患者（女9例、男5例）完成研究。每周给予紫杉醇（80 mg/m2）治疗，3周为1个疗程，分析紫杉醇相对剂量强度和毒副作用的发生率。采用常见不良反应事件评价标准4.0版（CTCAE v4.0）记录并分级治疗毒副作用，随访记录患者的总生存期（OS），依据实体肿瘤的疗效评价标准（RECIST）评估客观缓解率。结果　患者行紫杉醇化疗疗程的中位数为10个疗程。在治疗的最初2个疗程紫杉醇相对剂量强度>80.0％。未发生严重的毒副作用，最常见的毒副作用是贫血（85.7％）、白细胞计数减少（71.4%）、脱发（71.4％）。6例（42.9％）患者观察到3级及以上的毒副作用。14例患者的OS中位数为10.4个月，6个月和12个月生存率分别为85.7％和42.9％。Ⅳa、Ⅳb、Ⅳc期患者12个月生存率分别为80.0％、16.7％、0。Ⅳb、Ⅳc期患者的生存期较Ⅳa期患者短（χ2=7.627、10.317，P<0.001）。3例（21.4%）患者部分缓解（PR），5例（35.7％）患者病变稳定（SD），6例（42.9%）患者PD，客观缓解率为21.4％。PD患者的进展时间为0.4~26.3个月（中位数为1.6个月）。4例Ⅳa期和2例Ⅳb期患者在术后辅以放射治疗，存活时间为15.5个月，较未接受放射治疗患者的生存期（8.5个月）长（P=0.016）。结论　对ATC患者客观、准确和规范化使用紫杉醇进行治疗具有较高的客观缓解率和较低的毒副作用发生率，安全性和有效性均较好。

关键词: 甲状腺肿瘤；放化疗, 辅助；紫杉醇；生存曲线