Combined chemotherapy and irradiation in anaplastic thyroid carcinoma

Background: Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive cancer; patient's death usually occurs rapidly after diagnosis with a mean survival of six months in the majority of individual research series. Treatment of ATC ranges from surgery, radiotherapy, chemotherap...

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Main Authors: Pejčić Ivica, Vrbić Svetislav, Šćekić Mirjana
Format: Article
Language:English
Published: Institute of Oncology, Sremska Kamenica, Serbia 2003-01-01
Series:Archive of Oncology
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0354-7310/2003/0354-73100303187P.pdf
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spelling doaj-0b6ca68faa1349d4ad8be91613835fa72020-11-25T01:05:27ZengInstitute of Oncology, Sremska Kamenica, SerbiaArchive of Oncology0354-73102003-01-0111318718710.2298/AOO0303187PCombined chemotherapy and irradiation in anaplastic thyroid carcinomaPejčić IvicaVrbić SvetislavŠćekić MirjanaBackground: Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive cancer; patient's death usually occurs rapidly after diagnosis with a mean survival of six months in the majority of individual research series. Treatment of ATC ranges from surgery, radiotherapy, chemotherapy, or a combination of these regimes. Yet, the optimal sequence of treatment modalities has not been established. Methods: From 1997 to 2002 six consecutive patients with a histological diagnosis of ATC were treated with combined chemotherapy and irradiation at our Clinic for Oncology, Clinical Center Ni¹. Five of these patients were females and 1 male, aged between 28 and 71 years (mean age: 57 years). None of them had distant metastases at the time of diagnosis. Extrathyroidal extension was present in 3 patients with invasion into skin and hypoderm. Treatment consisted of doxorubicin 60 mg/m 2 plus cisplatin 60 mg/m 2 every three weeks. Total doses ranged between 158-375 mg/m 2 for doxorubicin and 183-380 mg/m 2 for cisplatin. External beam radiation to the neck was administered, at a daily dose of 1.2 Gy, up to total doses ranging between 45-60 Gy. Results: One patient achieved a complete response (CR) and one patient achieved a partial response (PR). Three patients had stable disease. One patient with CR progressed during follow-up and died 18 months from bone and brain metastases. The treatment was moderately well tolerated, although all patients experienced some mild form of toxicity; neutropenia occurred in all patients, but none of them required hospital admission. Median survival was 8 months (range: 4-18 months). Conclusion: We concluded that the present regimen produces meaningful responses for patients with localized ATC. A randomized study is needed to determine the effect on survival. http://www.doiserbia.nb.rs/img/doi/0354-7310/2003/0354-73100303187P.pdfthyroid neoplasmscarcinomaradiotherapyantineoplastic combined chemotherapy protocols
collection DOAJ
language English
format Article
sources DOAJ
author Pejčić Ivica
Vrbić Svetislav
Šćekić Mirjana
spellingShingle Pejčić Ivica
Vrbić Svetislav
Šćekić Mirjana
Combined chemotherapy and irradiation in anaplastic thyroid carcinoma
Archive of Oncology
thyroid neoplasms
carcinoma
radiotherapy
antineoplastic combined chemotherapy protocols
author_facet Pejčić Ivica
Vrbić Svetislav
Šćekić Mirjana
author_sort Pejčić Ivica
title Combined chemotherapy and irradiation in anaplastic thyroid carcinoma
title_short Combined chemotherapy and irradiation in anaplastic thyroid carcinoma
title_full Combined chemotherapy and irradiation in anaplastic thyroid carcinoma
title_fullStr Combined chemotherapy and irradiation in anaplastic thyroid carcinoma
title_full_unstemmed Combined chemotherapy and irradiation in anaplastic thyroid carcinoma
title_sort combined chemotherapy and irradiation in anaplastic thyroid carcinoma
publisher Institute of Oncology, Sremska Kamenica, Serbia
series Archive of Oncology
issn 0354-7310
publishDate 2003-01-01
description Background: Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive cancer; patient's death usually occurs rapidly after diagnosis with a mean survival of six months in the majority of individual research series. Treatment of ATC ranges from surgery, radiotherapy, chemotherapy, or a combination of these regimes. Yet, the optimal sequence of treatment modalities has not been established. Methods: From 1997 to 2002 six consecutive patients with a histological diagnosis of ATC were treated with combined chemotherapy and irradiation at our Clinic for Oncology, Clinical Center Ni¹. Five of these patients were females and 1 male, aged between 28 and 71 years (mean age: 57 years). None of them had distant metastases at the time of diagnosis. Extrathyroidal extension was present in 3 patients with invasion into skin and hypoderm. Treatment consisted of doxorubicin 60 mg/m 2 plus cisplatin 60 mg/m 2 every three weeks. Total doses ranged between 158-375 mg/m 2 for doxorubicin and 183-380 mg/m 2 for cisplatin. External beam radiation to the neck was administered, at a daily dose of 1.2 Gy, up to total doses ranging between 45-60 Gy. Results: One patient achieved a complete response (CR) and one patient achieved a partial response (PR). Three patients had stable disease. One patient with CR progressed during follow-up and died 18 months from bone and brain metastases. The treatment was moderately well tolerated, although all patients experienced some mild form of toxicity; neutropenia occurred in all patients, but none of them required hospital admission. Median survival was 8 months (range: 4-18 months). Conclusion: We concluded that the present regimen produces meaningful responses for patients with localized ATC. A randomized study is needed to determine the effect on survival.
topic thyroid neoplasms
carcinoma
radiotherapy
antineoplastic combined chemotherapy protocols
url http://www.doiserbia.nb.rs/img/doi/0354-7310/2003/0354-73100303187P.pdf
work_keys_str_mv AT pejcicivica combinedchemotherapyandirradiationinanaplasticthyroidcarcinoma
AT vrbicsvetislav combinedchemotherapyandirradiationinanaplasticthyroidcarcinoma
AT scekicmirjana combinedchemotherapyandirradiationinanaplasticthyroidcarcinoma
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