Treatment of 37 patients with anaplastic carcinoma of the thyroid

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Abstract
Most patients with anaplastic carcinoma of the thyroid die within several months of diagnosis, and aggressive treatment is uncommon. We evaluated the effect of active multimodal treatment (surgery, radiotherapy, and chemotherapy) on this disease, including one patient treated with autologous bone marrow transplantation and high-dose chemotherapy. The outcome was assessed in 37 patients with anaplastic thyroid carcinoma treated between 1971 and 1993. Patients without distant metastasis when initially seen underwent surgery followed by radiotherapy. From 1984, conventional radiotherapy was replaced by hyperfractionated radiotherapy. All but three patients died within 1 year of diagnosis. Patients with primary lesions less than 5 cm in diameter who had complete resection and radiotherapy survived significantly longer than the other patients, and hyperfractionated radiotherapy was effective for local control. Active multimodal therapy is indicated for early-stage anaplastic carcinoma of the thyroid.