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Anaplastic giant cell thyroid carcinoma.

G Wallin1, G Lundell, J Tennvall

  • 1Department of Surgery, Karolinska University Hospital, Stockholm, Sweden. goran.k.wallin@karolinska.se

Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society
|January 22, 2005
PubMed
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Anaplastic thyroid carcinoma (ATC) is aggressive, but combined treatment including radiotherapy and doxorubicin achieved local control in most patients. Surgery following this regimen prevented local recurrence in all treated cases, offering hope for cure.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiotherapy

Background:

  • Anaplastic (giant cell) thyroid carcinoma (ATC) is a rare but highly aggressive malignancy with a poor prognosis.
  • Median survival is typically 3-6 months, with death often resulting from local tumor growth and suffocation.
  • Diagnosis is feasible via fine needle aspiration biopsy, and cytological diagnosis is generally straightforward for experienced professionals.

Purpose of the Study:

  • To evaluate the efficacy of a combined modality treatment regimen for anaplastic thyroid carcinoma (ATC).
  • To assess the potential for achieving local tumor control and improving survival outcomes in ATC patients.
  • To explore novel therapeutic strategies for this aggressive thyroid cancer.

Main Methods:

  • A combined regimen involving preoperative hyperfractionated radiotherapy (1.6Gy x 2 daily to 46 Gy) and weekly intravenous doxorubicin (20 mg).

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  • Surgery was performed 2-3 weeks post-radiotherapy.
  • The regimen was applied to 22 patients with ATC, 17 of whom underwent surgery.

    • Main Results:

    • Local control was achieved in the majority of patients treated with the combined modality regimen.
    • None of the 17 patients who underwent surgery after the combined treatment experienced local recurrence.
    • The study highlights the importance of controlling the primary tumor to improve quality of life.

    Conclusions:

    • Combined modality treatment, including preoperative radiotherapy and doxorubicin followed by surgery, can effectively achieve local control and prevent recurrence in anaplastic thyroid carcinoma.
    • While cure remains challenging, controlling the primary tumor is crucial for improving patient quality of life.
    • Future research directions include exploring novel therapies like angiogenesis inhibitors and gene therapy for dedifferentiated thyroid carcinomas.