Yongli Yu

Shanghai Jiao Tong University, Shanghai, Shanghai Shi, China

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Publications (6)18.63 Total impact

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    ABSTRACT: Sorafenib has shown promise in the treatment of patients with advanced or metastatic thyroid carcinoma. However, its therapeutic effect has not been assessed in patients with brain metastases from follicular thyroid carcinoma (FTC). Here, we report a patient in whom this treatment was employed with a relatively favorable response. A 56-year-old woman had a thyroidectomy 8 years previously for FTC. She subsequently developed lung metastases, for which she received seven courses of radioiodine ((131)I) therapy. She developed right hemiplegia and other symptoms and was found to have a ≈ 5-cm lesion in the left parietal lobe. Radiosurgery with a total dose of 28 Gy (7 Gy/day, for 4 days) to treat her brain metastatic lesion was ineffective, and she was referred to us. We treated her with sorafenib, 200 mg orally, on a twice-daily basis. The effect of this intervention was assessed clinically and radiographically using Response Evaluation Criteria in Solid Tumors (RECIST). Symptoms and signs improved dramatically and continuously after initiation of sorafenib treatment. Partial response (PR) in the brain metastasis and stable disease (SD) in lung metastatic lesions were verified by consecutive imaging findings for more than one year. Despite alopecia, other treatment-related adverse events did not occur. Targeted therapy such as with sorafenib could be an effective alternative therapeutic strategy in the treatment of progressive brain metastasis from differentiated thyroid carcinoma (DTC) when surgery, external beam radiation, and (131)I are not suitable or give poor outcomes. A paradigm of sustained low dose of sorafenib (200 mg,twice a day) may be well-tolerated without compromising maintenance of the therapeutic effect.
    Thyroid: official journal of the American Thyroid Association 08/2012; 22(8):856-60. · 2.60 Impact Factor
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    ABSTRACT: Background: Sorafenib has shown promise in the treatment of patients with advanced or metastatic thyroid carcinoma. However, the therapeutic effect has not been assessed in patients with brain metastases from follicular thyroid carcinoma (FTC). Here we report a patient in whom this treatment was employed with a relatively favorable response. Patient and Methods: A 56-year-old women had a thyroidectomy 8 years previously for FTC. She subsequently developed lung metastases for which she received 7 courses of radioiodine (131I) therapy. She developed right hemiplegia and other symptoms and was found to have an approximately 5 cm lesion in the left parietal lobe. Radiosurgery with a total dose of 28 Gy (7 Gy/d, for four days) to treat her brain metastatic lesion was ineffective and she was referred to us. We treated her with sorafenib, 200 p.o on a b.i.d basis. The effect of this intervention was assessed clinically and radiographically using RECIST. Summary: Symptoms and signs improved dramatically and continuously after initiation of sorafenib treatment. Partial response in brain metastasis and stable disease in lung metastatic lesions were verified by consecutive imaging findings for more than one year. Despite alopecia, other treatment-related adverse events did not occur. Conclusions: Targeted therapy such as with sorafenib could be an effective alternative therapeutic strategy in the treatment of progressive brain metastasis from DTC when surgery, external beam radiation, and 131I are not suitable or give poor outcomes. A paradigm of sustained low dose of sorafenib (200 mg, b.i.d.) may be well tolerated without compromising maintenance of the therapeutic effect.
    Thyroid: official journal of the American Thyroid Association 05/2012; · 2.60 Impact Factor
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    ABSTRACT: Sorafenib has shown promise in the treatment of patients with advanced or metastatic thyroid carcinoma. However, the optimal dose has not been established and data on Chinese population are not available. We conducted a study to assess the responses to sorafenib at a low dose of 200 mg twice daily in patients with progressive radioiodine-refractory pulmonary metastases from papillary thyroid carcinoma (PTC). Eligible patients received sorafenib 200 mg orally twice daily. Responses were assessed using Response Evaluation Criteria in Solid Tumors and adverse events were assessed periodically. The end points included response rate and progression-free survival. Nine patients with radioiodine-refractory PTC were enrolled in the study and treated for a minimum of 13 weeks. The objective partial response rate was 33%. The stable disease rate was 44%. The mean progression-free survival was 42 weeks (95% confidence interval, 29.5 to 53.9). Two patients showed disease progression, and one of them died at 4 months after beginning of treatment. There was a marked and rapid change in the serum thyroglobulin level after start of treatment, with a mean decrease of 60% within 12 weeks, consistent with radiographic findings. Although the types of toxicities were consistent with other sorafenib trials, their severity was relatively mild. None of the patients discontinued sorafenib or reduced their dose because of treatment-related adverse events. Sorafenib at a dose of 200 mg twice daily has a potential therapeutic effect and is well tolerated in Chinese patients with PTC and radioiodine-refractory pulmonary metastases. Further study is warranted with a larger cohort of patients.
    Thyroid: official journal of the American Thyroid Association 02/2011; 21(2):119-24. · 2.60 Impact Factor
  • Thyroid: official journal of the American Thyroid Association 03/2010; 20(3):337-40. · 2.60 Impact Factor
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    ABSTRACT: (131)I whole-body scintigraphy (WBS) is a highly sensitive method for the detection of differentiated thyroid tumors and metastases. However, a lack of anatomic landmarks and the physiologic accumulation of the tracer complicate interpretation of the images. This prospective study was designed to evaluate the incremental value of (131)I SPECT/CT over planar WBS in the management of patients with differentiated thyroid carcinoma (DTC). Planar imaging was performed on 66 consecutive DTC patients who were considered to have locally advanced or metastatic disease after total or nearly total thyroidectomy. SPECT/CT was added for patients whose planar findings were inconclusive. The planar images were interpreted by 2 experienced nuclear medicine physicians. Interpretation of the SPECT/CT images was a consensus opinion of one of the nuclear medicine physicians and an experienced radiologist. Fusion images were considered to improve image interpretation when they better localized sites of increased (131)I uptake. The final diagnosis was verified by pathologic findings, other imaging modalities, and clinical follow-up. Both site-based and patient-based analyses were performed, and the impact of SPECT/CT results on therapeutic strategy was assessed. A total of 232 foci were observed by (131)I WBS, including 33.2% of foci localized in the thyroid bed, 62.1% due to malignant lesions, and 4.7% caused by nonthyroidal physiologic or benign uptake or a contaminant. Overall, 37 SPECT/CT studies were performed on 23 patients, whose planar images showed 81 inconclusive lesions. Precise localization and characterization of (131)I-avid foci were achieved through (131)I SPECT/CT in 69 (85.2%) and 67 (82.7%) of the 81 foci, respectively. Fusion images were considered to be of benefit in 17 (73.9%) of 23 patients. The therapeutic strategy was changed in 8 (47.1%) of 17 patients. Uncommon metastatic lesions were found in 9 (13.6%) of 66 patients with regard to SPECT/CT fusion images. Fusion of SPECT and CT images was of incremental value over WBS in increasing diagnostic accuracy, reducing pitfalls, and modifying therapeutic strategies in 73.9% of DTC patients. As SPECT/CT techniques emerge, (131)I SPECT/CT may demonstrate higher value than WBS in the management of DTC.
    Journal of Nuclear Medicine 12/2008; 49(12):1952-7. · 5.77 Impact Factor
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    ABSTRACT: To investigate the analytical interference between serum Tg and TgAb. Tg and TgAb were measured on an automated chemiluminescent immunoassay system in mixed sera from DTC patients and individual samples spiked with exogenous Tg. Tg and TgAb recoveries in mixed patient samples were inversely correlated with expected TgAb or Tg concentrations, respectively. Impaired TgAb recoveries were also found in 50% (10/20) samples with high Tg in the exogenous recovery tests. Mutual but not equal analytical interference between Tg and TgAb is present and concentration-dependent with interpatient variability.
    Clinical Biochemistry 07/2007; 40(9-10):735-8. · 2.45 Impact Factor