Treatment of advanced medullary thyroid cancer with an alternating combination of 5 FU-streptozocin and 5 FU-dacarbazine

Abstract

Combinations of 5-fluorouracil (5-FU) and streptozocin and 5-FU and dacarbazine were given alternately to 20 patients with metastatic medullary thyroid carcinoma. Three partial responses and 11 long-term stabilizations were observed. No unexpected toxicity occurred.

Treatment of medullary thyroid carcinoma: an update.

“…In this series, eight patients underwent radiotherapy for inoperable tumours: of these, one presented complete remission, two a regression of more than 50% of the tumour and four experienced significant palliation, with a reduction of less than 50% of the bulk. More recent experiences confirm the positive results of external radiotherapy, which can induce long-term stabilisation in some patients with inoperable or incompletely excised tumours (Schlumberger & Pacini 1999). Brierley et al (1996) studied 40 patients with high risk of recurrency (microscopic residual disease, extraglandular invasion or lymph-node involvement): the local/regional relapse-free rate at 10 years was significantly higher in 25 patients with post-operative beam radiation as compared with 15 patients treated with surgery alone (86% vs 52%).…”

“…Due to the long half-life of circulating CEA and the different half-lives of the calcitonins (Fugazzola et al 1994), serum marker measurements should be performed 2 months following surgery (Schlumberger & Pacini 1999). In patients with normalisation of the tumour markers, stimulated peak plasma calcitonin levels have been reported to be more effective than basal concentrations in detecting occult disease after thyroidectomy (Tisell et al 1996, Giuffrida & Gharib 1998.…”

“…Permanent post-operative hypoparathyroidism should be limited to approximately 1% (Van Heerden et al 1987). Schlumberger & Pacini (1999) recommend the removal of three glands with reimplantation of a portion of the remaining gland in patients with concomitant hyperparathyroidism with diffuse parathyroid hyperplasia (MEN 2A syndrome).…”

“…The parathyroid glands should be identified and preserved during surgery; if they appear to be normal, they can be left in place, or immediately transplanted in a sternocleidomastoid or in a non-dominant forearm muscle (Schlumberger & Pacini 1999). Permanent post-operative hypoparathyroidism should be limited to approximately 1% (Van Heerden et al 1987).…”

“…Thus, in patients with palpable tumours, routine total thyroidectomy with central and bilateral functional neck dissection has been recommended (Moley & DeBenedetti 1999). A systematic lymph-node dissection of the lower two-thirds of the jugulo-carotid chain has also been proposed as a routine procedure: should metastatic regional nodes be identified, a standard modified (functional) radical neck dissection is recommended (Schlumberger & Pacini 1999).…”