Anaplastic carcinoma of the thyroid gland treated by radiation therapy

A retrospective review was performed to investigate the potential role of external beam radiation therapy with or without chemotherapy in anaplastic carcinoma of the thyroid.

Fifty-one patients with a histologically or cytologically proven anaplastic thyroid carcinoma, treated by external beam radiation therapy between January 1970 and December 1986 in the Dr. Daniel den Hoed Cancer Center are the subject of this report. The overall survival, local control rate and pattern of metastasis were analyzed.

It was found that the impact of lung metastases and local relapse on survival was appreciable. Patients with metastases but locally free of tumor achieved a median survival of 7.5 months. In patients with local regional residual disease after therapy, an actuarial risk of death of 100% at 8 months and a median survival of 1.6 months was observed. For patients without disease at the end of radiation therapy, an actuarial median survival of 8 months was observed.

This retrospective analysis supports the data from the literature that local control is indispensable for achieving a higher short-term survival rate, whereas even with local regional control patients might still die soon after the completion of their treatment because of distant metastases, predominantly in the lungs. A potentially new way of treatment, that is the combination of low dose Adriamycin with hyperfractionated external beam radiation therapy to the primary tumor and prophylactic irradiation to the lung, in order to obtain higher locoregional control and diminishing of distant metastases is briefly discussed.