Anaplastic thyroid cancer: Prognostic factors, patterns of care, and overall survival

Glaser, Scott; Mandish, Steven; Gill, Beant S.; Balasubramani, Goundappa K.; Clump, D.A.; Beriwal, Sushil

doi:10.1002/hed.24384

Cited by 101 publications

(123 citation statements)

References 37 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…Sugitani et al [6] reported that a total radiation dose ≥40 Gy was an independent predictor for OS, and Dumke et al [7] reported that a total radiation dose ≥50 Gy was a significant predictor for OS in univariate analysis. Glaser et al [10] compared three total radiation dose groups, ≤36 Gy, 36.1-59.3 Gy, and ≥59.4 Gy, and reported that a total radiation dose ≥59. 4 Gy was an independent predictor for OS in 3,552 patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hypofractionated Radiotherapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution

et al. 2018

View full text Add to dashboard Cite

Background: Anaplastic thyroid carcinoma (ATC) is a rare cancer and has a poor prognosis. Several radiation protocols have been reported, but the results were not satisfactory. Objective: The aim of this study was to determine the effect of hypofractionated radiotherapy. Methods: Thirty-three patients who received radiotherapy for ATC between January 2000 and December 2014 were retrospectively included. We defined hypofractionated radiotherapy as a single dose ≥5 Gy. Results: Nineteen patients were treated with hypofractionated radiotherapy. Twenty-eight patients died, and 27 of those patients died from ATC. Sixteen patients died from distant metastasis and 6 from local recurrence. In the hypofractionated radiotherapy group, local recurrence occurred in 5 patients and 1 of them died from active bleeding from a local tumor. There was local recurrence in 7 patients who received the other protocol, and 5 of them died from asphyxiation, active bleeding, or uncontrollable growth of a local tumor on the neck. The median overall survival (OS) was 5 months. In multivariate analysis, patients who received an equivalent dose in 2-Gy fractions (EQD₂) ≥50 Gy had significantly better OS (p = 0.016). In univariate analysis, patients who received hypofractionated radiotherapy did not have significantly better OS (p = 0.872) or local control (p = 0.090). The χ² test showed that significantly fewer patients died from local recurrence in the hypofractionated radiotherapy group (p = 0.025). Conclusions: Multivariate analysis showed that an EQD₂ ≥50 Gy resulted in better OS, and hypofractionated radiotherapy decreased the rate of mortality from local recurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The median OS in their study was 9.3 months. Glaser et al [10] and Pezzi et al [11] reported that radiotherapy with a high total dose improved the OS of ATC patients.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated Radiotherapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Taxanes, doxorubicin, and platins have shown activity as a single or combined agents with response rates ranging from 15% to 25% 41 . The combined RT and chemotherapy regimens with doxorubicin with or without taxanes or cisplatin combined with RT have shown the most promising results 19,42 . In the current study, chemotherapy was administered to few patients (n=7) and did not influence OS.…”

Section: Discussionmentioning

confidence: 99%

“…Multivariate analysis, identified white blood cell count, surgery, and post-operative RT as independent prognostic factors in ATC patients. According to Glaser et al, age and tumor size may be prognostic factors in ATC patients 19 . Our results did not identify sex, stage, surgery or RT as significant predictors of survival by multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment Outcome and Prognostic Factors of Anaplastic Thyroid Carcinoma: A Single Institution Experience in Egypt

Ibrahim

Askoura

2018

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

View full text Add to dashboard Cite

Introduction: Anaplastic thyroid carcinoma (ATC) is a rare lethal malignancy. It is one of the most aggressive human malignancies with limited progress in finding effective therapies. Aim: We aimed to study the treatment outcome and prognostic factors of ATC patients treated at our institution. Methods: We retrospectively analyzed charts of 30 ATC patients, treated at the Clinical Oncology Department, AinShams University from 2006 to 2017. The clinical characteristics and factors affecting survival were studied. Kaplan-Meier survival curve was used to analyze the overall survival (OS) of the patients. Results: The median age of patients was 60 years and males represented 63% of them. Almost half of patients (47%) had stage IVA disease. Equal number of patients received combined modality treatment versus single modality treatment (37% each). The median OS was 3 months (95% Confidence interval: 1.429-4.571). Variables associated with significantly better OS in univariate analysis included male sex (p=0.04), stage IVA disease (p=0.012), surgical treatment (p=0.034), radiotherapy (p=0.003), and combined modality treatment (p=0.005). However, only female sex was identified as significant poor prognostic variable of OS (p=0.043) by multivariate analysis. Conclusion: Our results of treatment outcome and prognosis of ATC agree with most of the literature. Multimodality treatment is currently the standard of care. While still there is no successful treatment of this rapidly fatal disease, exploration of novel therapies and approaches are warranted to help improve the outcome.

show abstract

Association of Treatment Strategies and Tumor Characteristics With Overall Survival Among Patients With Anaplastic Thyroid Cancer

Lamarre

Yalamanchali

et al. 2023

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

ImportanceSurvival outcomes for anaplastic thyroid cancer (ATC), the most aggressive subtype of thyroid cancers, have remained poor. However, targeted therapies and immunotherapies present new opportunities for treatment of this disease. Evaluations of survival outcomes over time with new multimodal therapies are needed for optimizing treatment plans.ObjectiveTo evaluate the association of treatment strategies and tumor characteristics with overall survival (OS) among patients with ATC.Design, Setting, and ParticipantsThis retrospective case series study evaluated the survival outcomes stratified by treatment strategies and tumor characteristics among patients with ATC treated at a tertiary level academic institution from January 1, 2000, to December 31, 2021. Demographic, tumor, treatment, and outcome characteristics were analyzed. Kaplan-Meier method and log rank test modeled OS by treatment type and tumor characteristics. Data were analyzed in May 2022.Main Outcomes and MeasuresOverall survival (OS).ResultsThe study cohort comprised 97 patients with biopsy-proven ATC (median [range] age at diagnosis, 70 [38-93] years; 60 (62%) female and 85 [88%] White individuals; 59 [61%] never smokers). At ATC diagnosis, 18 (19%) patients had stage IVA, 19 (20%) had stage IVB, and 53 (55%) had stage IVC disease. BRAF status was assessed in 38 patients; 18 (47%) had BRAF-V600E variations and 20 (53%), BRAF wild type. Treatment during clinical course included surgery for 44 (45%) patients; chemotherapy, 41 (43%); definitive or adjuvant radiation therapy, 34 (RT; 35%); and targeted therapy, 28 (29%). Median OS for the total cohort was 6.5 (95% CI, 4.3-10.0) months. Inferior OS was found in patients who did not receive surgery (hazard ratio [HR], 2.12; 95% CI, 1.35-3.34; reference, received surgery), chemotherapy (HR, 3.28; 95% CI, 1.99-5.39; reference, received chemotherapy), and definitive or adjuvant RT (HR, 2.47; 95% CI, 1.52-4.02; reference, received definitive/adjuvant RT). On multivariable analysis, age at diagnosis (HR, 1.03; 95% CI, 1.01-1.06), tumor stage IVC (HR, 2.65; 95% CI, 1.35-5.18), and absence of definitive or adjuvant RT (HR, 1.90; 95% CI, 1.01-3.59) were associated with worse OS.Conclusions and RelevanceThis retrospective single-institution study found that lower tumor stage, younger age, and the ability to receive definitive or adjuvant RT were associated with improved OS in patients with ATC.

show abstract

Anaplastic thyroid cancer: Prognostic factors, patterns of care, and overall survival

Abstract: Even after correction for selection and immortal time bias, high-dose RT resulted in improved survival. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2083-E2090, 2016.

Cited by 101 publications

References 37 publications

Hypofractionated Radiotherapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution

Hypofractionated Radiotherapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution

Treatment Outcome and Prognostic Factors of Anaplastic Thyroid Carcinoma: A Single Institution Experience in Egypt

Association of Treatment Strategies and Tumor Characteristics With Overall Survival Among Patients With Anaplastic Thyroid Cancer

Contact Info

Product

Resources

About