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Anaplastic thyroid carcinoma: a new approach

W J Simpson

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |January 1, 1980
    PubMed
    Summary

    Anaplastic thyroid carcinoma has a poor prognosis. Hyperfractionation radiation therapy showed promising tumor regression in patients, but increased toxicity when combined with Adriamycin.

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    Area of Science:

    • Oncology
    • Radiation Oncology

    Background:

    • Anaplastic thyroid carcinoma (ATC) has a dismal prognosis, with less than 10% of patients surviving 5 years with conventional treatment.
    • Disease-free survivors at 2 years post-treatment for ATC appear to achieve a cure.

    Purpose of the Study:

    • To evaluate the efficacy of hyperfractionation radiation therapy in treating anaplastic thyroid carcinoma.
    • To assess the toxicity profile of hyperfractionation, particularly when combined with Adriamycin.

    Main Methods:

    • Investigated the administration of large radiation fractions (350-800 rads) in 14 patients with ATC.
    • Assessed the outcomes of hyperfractionation (100 rads qid at 3-hour intervals) in 14 ATC patients.
    • Examined the impact of concurrent Adriamycin administration on radiation toxicity.

    Main Results:

    • Large, infrequent radiation fractions failed to eradicate local disease in 14 patients, all succumbing within 9 months.
    • Hyperfractionation resulted in complete tumor regression in 6 of 14 patients and partial regression in 7 others.
    • Two patients died from spinal cord necrosis and one from pneumonitis, linked to concurrent Adriamycin use.

    Conclusions:

    • Hyperfractionation demonstrates significant tumor regression potential in anaplastic thyroid carcinoma.
    • Effective systemic therapy is crucial for maximizing the benefit of hyperfractionation in ATC.
    • Increased radiation toxicity, including fatal events, was observed with concurrent Adriamycin administration.

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