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Open Access Research article

Outcome after intensity modulated radiotherapy for anaplastic thyroid carcinoma

Xiayun He1, Duanshu Li2, Chaosu Hu1, Zhuoying Wang2, Hongmei Ying1 and Yi Wu2*

Author Affiliations

1 Department of Radiation Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai 200032, China

2 Department of Head and Neck Surgery, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai 200032, China

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BMC Cancer 2014, 14:235  doi:10.1186/1471-2407-14-235

Published: 2 April 2014

Abstract

Background

Anaplastic thyroid carcinoma (ATC) is a malignancy with one of the highest fatality rates. We reviewed our recent clinical experience with intensity modulated radiotherapy (IMRT) combined with surgery and chemotherapy for the management of ATC.

Methods

13 patients with ATC who were treated by IMRT in our institution between October 2008 and February 2011, have been analyzed. The target volume for IMRT was planned to include Gross tumor volume (GTV): primary tumor plus any N + disease (66 Gy/33 F/6.6 W), with elective irradiation of thyroid bed, bilateral level II through VI and mediastinal lymph nodes to the level of the carina (54-60 Gy). Seven patients received surgical intervention and eleven patients had chemotherapy.

Results

The median radiotherapy dose to GTV was 60 Gy/30 fractions/6 weeks. The median survival time of the 13 patients was 9 months. The direct causes of death were distant metastases (75%) and progression of the locoregional disease (25%). Ten patients were spared dyspnea and tracheostomy because their primary neck lesion did not progress.

Conclusion

The results showed that IMRT combined by surgery and chemotherapy for ATC might be beneficial to improve locoregional control. Further new therapies are needed to control metastases.

Keywords:
Anaplastic thyroid carcinoma; ATC; Intensity modulated radiotherapy; Locoregional control; Distant metastases