Concurrent doxorubicin and radiotherapy for anaplastic thyroid cancer: A critical re-evaluation including uniform pathologic review Journal Article


Authors: Sherman, E. J.; Lim, S. H.; Ho, A. L.; Ghossein, R. A.; Fury, M. G.; Shaha, A. R.; Rivera, M.; Lin, O.; Wolden, S.; Lee, N. Y.; Pfister, D. G.
Article Title: Concurrent doxorubicin and radiotherapy for anaplastic thyroid cancer: A critical re-evaluation including uniform pathologic review
Abstract: Background and purpose: Anaplastic thyroid carcinoma (ATC) is a rare, aggressive malignancy. The potential for pathologic misclassification complicates interpretation of published data. One standard treatment option for locoregionally advanced disease is weekly low-dose doxorubicin with concurrent radiation therapy, and was previously developed at our institution. We evaluated our more recent experience with this approach, which included pathologic confirmation of all cases. Materials and methods: A retrospective review was performed on patients identified through the Memorial Sloan-Kettering Cancer Center (MSKCC) Cancer Database. Inclusion criteria: pathologically confirmed ATC; locoregional disease encompassable within a radiation portal; treatment with curative intent at MSKCC with planned weekly doxorubicin (10 mg/m 2) and concurrent radiation. Principle outcomes assessed were locoregional progression-free survival (LR-PFS) and overall survival (OS). Results: Thirty-seven patients were included. Median radiotherapy dose was 57.6 Gy, and was ≥50 Gy in 29 (78%), administered through hyperfractionated or once-daily schedules. One-year outcomes were LR-PFS, 45%; OS, 28%. Conclusion: The prognosis of patients with ATC remains grim and our current results appear inferior to those reported previously by our institution. More accurate histologic diagnoses and patient selection in the present series compared to the prior one may be responsible in part. Better therapy is desperately needed for this aggressive disease. © 2011 Elsevier Ireland Ltd. All rights reserved.
Keywords: adult; cancer survival; clinical article; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; overall survival; neutropenia; doxorubicin; radiation dose; outcome assessment; follow up; low drug dose; progression free survival; multiple cycle treatment; mucosa inflammation; drug fever; survival time; radiation dose fractionation; thyroid cancer; thyroid neoplasms; antibiotics, antineoplastic; anaplastic carcinoma; chemoradiotherapy; anaplastic thyroid cancer; chemotherapy/radiation therapy; failure to thrive
Journal Title: Radiotherapy and Oncology
Volume: 101
Issue: 3
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2011-12-01
Start Page: 425
End Page: 430
Language: English
DOI: 10.1016/j.radonc.2011.09.004
PROVIDER: scopus
PUBMED: 21981877
DOI/URL:
Notes: --- - "Export Date: 3 January 2012" - "CODEN: RAOND" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Ronald A Ghossein
    482 Ghossein
  2. Ashok R Shaha
    697 Shaha
  3. Suzanne L Wolden
    560 Wolden
  4. Eric J Sherman
    339 Sherman
  5. Michael Rivera
    35 Rivera
  6. Su Hsien Lim
    3 Lim
  7. Oscar Lin
    307 Lin
  8. Nancy Y. Lee
    871 Lee
  9. David G Pfister
    389 Pfister
  10. Matthew G Fury
    102 Fury
  11. Alan Loh Ho
    237 Ho