Multimodal therapy in anaplastic giant cell thyroid carcinoma

Werner, B.; Abele, John S.; Alveryd, A; Björklund, Anders; Franzén, S.; Granberg, Per‐Ola; Landberg, T.; Lundell, G. E. F.; Löwhagen, T; Sundblad, R.; Tennvall, Jan

doi:10.1007/bf01658365

Cited by 52 publications

(11 citation statements)

References 24 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, most patients promptly developed distant metastases and died from tumor-related causes. Other authors found similar results with combined radiochemotherapy [25,26].…”

Section: Combined Therapeutic Modalitysupporting

confidence: 63%

External Radiotherapy of Thyroid Cancer

Pöllinger

Dühmke

2001

Oncol Res Treat

View full text Add to dashboard Cite

Differentiated thyroid cancer comprises papillary, mixed papillary-follicular and follicular adenocarcinomas. They are mostly hormone-sensitive and respond to thyroid-stimulating hormone (TSH) suppression. The standard treatment is total thyroidectomy, ¹³¹I therapy and thyroid hormone suppression therapy. Adjuvant external radiotherapy is discussed controversially. Most authors recommend adjuvant external radiotherapy for extra-capsular tumor extension. Decision on an individual basis should be made for patients with lymph node involvement. In the case of incomplete surgical resection, external radiotherapy should be applied if second surgery is not possible. For medullary thyroid cancer, external beam radiotherapy seems to be beneficial for patients with surgically inaccessible disease, with microscopic residual or gross tumor after surgery, with recurrent locoregional disease, or with surgically unmanageable metastases. Patients suffering from anaplastic thyroid cancer should receive combined treatment consisting of extensive surgery, external irradiation with total doses up to 60 Gy, and chemotherapy. The combined treatment modality leads to higher local control rates and prolongs survival.

show abstract

“…However, most patients promptly developed distant metastases and died from tumor-related causes. Other authors found similar results with combined radiochemotherapy [25,26].…”

Section: Combined Therapeutic Modalitysupporting

confidence: 63%

External Radiotherapy of Thyroid Cancer

Pöllinger

Dühmke

2001

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

“…In previous studies by Tennvall et al and Werner et al, death from local failure was seen in 36% and 24% of patients, respectively. These studies used twice daily treatment schedules of varying doses and chemotherapy regimens [ 11 , 21 ]. In our study, death attributed to local failure was seen in 18% of patients, though the patients who developed local failure were inoperable at the time of diagnosis or only received a partial resection or biopsy.…”

Section: Discussionmentioning

confidence: 99%

Short Course High Dose Radiotherapy in the Treatment of Anaplastic Thyroid Carcinoma

Stavas

Shinohara

Attia

et al. 2014

Journal of Thyroid Research

View full text Add to dashboard Cite

.Purpose. Anaplastic thyroid carcinoma (ATC) is a rare but aggressive tumor with limited survival. To date, the ideal radiation treatment schedule, one that balances limited survival with treatment efficacy, remains undefined. In this retrospective series we investigate the effectiveness and tolerability of hypofractionated radiation therapy in the treatment of ATC. Methods. 17 patients with biopsy proven ATC treated between 2004 and 2012 were reviewed for outcomes and toxicity. All patients received short course radiation. Results. The most commonly prescribed dose was 54 Gy in 18 fractions. Median survival was 9.3 months. 47% of patients were metastatic at diagnosis and the majority of patients (88%) went on to develop metastasis. Death from local progression was seen in 3 patients (18%), 41% experienced grade 3 toxicity, and there were no grade 4 toxicities. Conclusions. Here we demonstrated the safety and feasibility of hypofractionated radiotherapy in the treatment of ATC. This approach offers shorter treatment courses (3-4 weeks) compared to traditional fractionation schedules (6-7 weeks), comparable toxicity, local control, and the ability to transition to palliative care sooner. Local control was dependent on the degree of surgical debulking, even in the metastatic setting.

show abstract

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16] However, to our knowledge, few published data have shown any significant survival benefit from multimodal therapy.…”

Section: Discussionmentioning

confidence: 99%

Anaplastic thyroid carcinoma

Kebebew

Greenspan

Clark

et al. 2005

Cancer

532

183

View full text Add to dashboard Cite

BACKGROUNDAnaplastic thyroid carcinoma (ATC) is rare but is one of the most aggressive human malignancies. Several prognostic factors have been observed in patients with ATC, and some experts advocate aggressive multimodal therapy in selected patients. However, it is unclear whether such an approach significantly improves survival. The authors analyzed prognostic factors and treatment outcomes in patients with ATC reported in the National Cancer Institute's Surveillance, Epidemiology, and End Results data base.METHODSThe cohort consisted of 516 patients with ATC reported to 12 population‐based cancer registries between 1973 and 2000. Demographic, pathologic, and treatment data were used for univariate and multivariate survival analyses.RESULTSThe mean patient age at diagnosis was 71.3 years, and there were 171 men and 345 women. Eight percent of patients had intrathyroidal tumors, 38% had extrathyroidal tumors and/or lymph node invasion, and 43% of patients had distant metastasis. The average tumor size was 6.4 cm (range, 1–15 cm). Sixty‐four percent of patients underwent surgical resection of their primary tumor, and 63% received external beam radiotherapy. The overall cause‐specific mortality rate was 68.4% at 6 months and 80.7% at 12 months. Univariate analysis showed that age < 60 years, female gender, intrathyroidal tumor, external beam radiotherapy, surgical resection, and combined surgical resection of tumor and radiotherapy were associated with a lower cause‐specific mortality. On multivariate analysis, only age < 60 years, an intrathyroidal tumor, and the combined use of surgical and external beam radiation therapy were identified as independent predictors of lower cause‐specific mortality.CONCLUSIONSAlthough most patients with ATC had an extremely poor prognosis, patients < 60 years old with intrathyroidal tumors survived longer. Surgical resection with external beam radiotherapy for ATC was associated with lower cause‐specific mortality. Cancer 2005. © 2005 American Cancer Society.

show abstract

Multimodal therapy in anaplastic giant cell thyroid carcinoma

Cited by 52 publications

References 24 publications

External Radiotherapy of Thyroid Cancer

External Radiotherapy of Thyroid Cancer

Short Course High Dose Radiotherapy in the Treatment of Anaplastic Thyroid Carcinoma

Anaplastic thyroid carcinoma

Contact Info

Product

Resources

About