Anaplastic thyroid cancer and hyperfractionated accelerated radiotherapy (HART) with and without surgery.
Anne-Birgitte JacobsenKrystyna K GrøholtBianca LorntzsenTerje A OsnesRagnhild Sørum FalkEva SigstadPublished in: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (2017)
Anaplastic carcinoma of the thyroid gland (ATC) is one of the most aggressive cancers in humans. With insufficient treatment, the disease most often leads to death in suffocation. From 2002, our treatment strategy has been hyperfractionated accelerated radiotherapy (HART) with high doses (64 Gy) to the neck, followed by surgery 4-8 weeks later if feasible, with the aim to gain control in the neck. After a pathology review, 51 patients were diagnosed with ATC in the period 2002-2014 in the south-east of Norway. Thirty-one received HART, and we present a study of these patients, with death in suffocation as the primary endpoint and survival as the second. No patients treated with HART died in suffocation. Six had a tracheostomy during their course of disease, of whom four were dependent on a tracheal cannula when they died. The best median survival, 19 months, was obtained in the 13 patients where both radiotherapy and surgery were possible as primary treatments. Only surgery came out as a prognostic factor for survival in multivariate analysis. Patients surviving more than 2 years were characterised by having surgery with R0 resection and no or small residual foci of ATC in the specimens. Stage 4C patients survived 3 months only.
Keyphrases
- prognostic factors
- end stage renal disease
- minimally invasive
- ejection fraction
- chronic kidney disease
- newly diagnosed
- coronary artery bypass
- peritoneal dialysis
- radiation therapy
- squamous cell carcinoma
- radiation induced
- atrial fibrillation
- patient reported outcomes
- intensive care unit
- obstructive sleep apnea
- young adults
- surgical site infection
- patient reported
- smoking cessation
- preterm birth