CHEMOTHERAPY WITH DACARBAZINE AND 5-FLUOROURACIL IN ADVANCED MEDULLARY-THYROID CANCER

Background: Experience with chemotherapeutic agents in the management of advanced medullary thyroid carcinoma (MTC) is limited and controver sial. However, since MTC is a neuroendocrine neoplasm, we considered t he possibility that cytotoxic drugs previously used in the treatment o f these tumours could also have activity in MTC. Patients and methods: Five patients (4 females and 1 male, aged 22-71 years) with locally a dvanced or metastatic MTC received 5 day intravenous courses of dacarb azine (DTIC) (250 mg/sqm) and 12 hour infusion 5-fluorouracil (450 mg/ sqm), given every 4 weeks. Six cycles were administered to 4 patients and four to 1 patient. Results: Three partial responses lasting 9, 10 and 8+ months were observed; one patient had stable disease and one p rogressive disease. Toxicity was acceptable with grade I thrombocytope nia and grade II leukopenia occurring in one patient, and grade II nau sea and vomiting in four patients. Conclusions: In our experience, tre atment of advanced thyroid carcinoma with DTIC and 5-FU appeared to ha ve significant activity and was well tolerated.