Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature

Introduction. Anaplastic thyroid carcinoma (ATC) is rare yet accounts for up to 50% of all thyroid cancer deaths. This study reviews outcomes of patients with confirmed ATC referred to a tertiary oncology centre plus reviews the literature to explore how poor outcomes may be improved. Materials and...

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Main Authors: Natalie M. Lowe, Sean Loughran, Nicholas J. Slevin, Beng K. Yap
Format: Article
Language:English
Published: Hindawi Limited 2014-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2014/674583
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spelling doaj-5209de763d3e4aeb89df12c6d6afa5c12020-11-24T21:32:33ZengHindawi LimitedThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/674583674583Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the LiteratureNatalie M. Lowe0Sean Loughran1Nicholas J. Slevin2Beng K. Yap3Head and Neck Surgery, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UKHead and Neck Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UKHead and Neck Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UKHead and Neck Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UKIntroduction. Anaplastic thyroid carcinoma (ATC) is rare yet accounts for up to 50% of all thyroid cancer deaths. This study reviews outcomes of patients with confirmed ATC referred to a tertiary oncology centre plus reviews the literature to explore how poor outcomes may be improved. Materials and Methods. The management and outcomes of 20 patients with ATC were reviewed. Results. Median age at diagnosis was 69.5 years. 19 patients died due to ATC, 40% of whom died from asphyxiation. Median survival for all cases was 59 days. Patients who had previous surgery prior to other treatment modalities had a longer median survival overall compared to those who had not had previous surgery (142 days compared to 59 days) and produced the one long-term survivor. Chemotherapy followed by radiotherapy (without previous surgery) was associated with longer median survival (220 days). Palliative radiotherapy alone did not decrease the rate of death by asphyxiation when compared to other single modality treatments. Conclusion. Multimodality treatment including surgery when feasible remains the best strategy to improve survival and prevent death from asphyxiation in the management of ATC. The addition of chemotherapy to our institutional protocol led to improved survival but prognosis remains very poor.http://dx.doi.org/10.1155/2014/674583
collection DOAJ
language English
format Article
sources DOAJ
author Natalie M. Lowe
Sean Loughran
Nicholas J. Slevin
Beng K. Yap
spellingShingle Natalie M. Lowe
Sean Loughran
Nicholas J. Slevin
Beng K. Yap
Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature
The Scientific World Journal
author_facet Natalie M. Lowe
Sean Loughran
Nicholas J. Slevin
Beng K. Yap
author_sort Natalie M. Lowe
title Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature
title_short Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature
title_full Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature
title_fullStr Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature
title_full_unstemmed Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature
title_sort anaplastic thyroid cancer: the addition of systemic chemotherapy to radiotherapy led to an observed improvement in survival—a single centre experience and review of the literature
publisher Hindawi Limited
series The Scientific World Journal
issn 2356-6140
1537-744X
publishDate 2014-01-01
description Introduction. Anaplastic thyroid carcinoma (ATC) is rare yet accounts for up to 50% of all thyroid cancer deaths. This study reviews outcomes of patients with confirmed ATC referred to a tertiary oncology centre plus reviews the literature to explore how poor outcomes may be improved. Materials and Methods. The management and outcomes of 20 patients with ATC were reviewed. Results. Median age at diagnosis was 69.5 years. 19 patients died due to ATC, 40% of whom died from asphyxiation. Median survival for all cases was 59 days. Patients who had previous surgery prior to other treatment modalities had a longer median survival overall compared to those who had not had previous surgery (142 days compared to 59 days) and produced the one long-term survivor. Chemotherapy followed by radiotherapy (without previous surgery) was associated with longer median survival (220 days). Palliative radiotherapy alone did not decrease the rate of death by asphyxiation when compared to other single modality treatments. Conclusion. Multimodality treatment including surgery when feasible remains the best strategy to improve survival and prevent death from asphyxiation in the management of ATC. The addition of chemotherapy to our institutional protocol led to improved survival but prognosis remains very poor.
url http://dx.doi.org/10.1155/2014/674583
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