TREATMENT OF 37 PATIENTS WITH ANAPLASTIC CARCINOMA OF THE THYROID

Background. Most patients with anaplastic carcinoma of the thyroid die within several months of diagnosis, and aggressive treatment is uncom mon. 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 che motherapy. Methods. The outcome was assessed in 37 patients with anapl astic thyroid carcinoma treated between 1971 and 1993. Patients withou t distant metastasis when initially seen underwent surgery followed by radiotherapy. From 1984, conventional radiotherapy was replaced by hy perfractionated radiotherapy. Results. All but three patients died wit hin 1 year of diagnosis. Patients with primary lesions less than 5 cm in diameter who had complete resection and radiotherapy survived signi ficantly longer than the other patients, and hyperfractionated radioth erapy was effective for local control. Conclusion. Active multimodal t herapy is indicated for early-stage anaplastic carcinoma of the thyroi d. (C) 1996 John Wiley & Sons, Inc.