Current approaches and perspectives in the therapy of medullary thyroid carcinoma

BACKGROUND. Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor der ived from parafollicular cells. At present, surgery is the most important t reatment for MTC. METHODS, We describe the current approaches of MTC treatment (surgery, chem otherapy, radiation therapy, and biologic therapy). RESULTS. MTC is currently approached surgically in the main part through to tal thyroidectomy and compartment-oriented microdissection of cervicomedias tinal lymph nodes. Substitutive l-thyroxine administration together with cl ose clinical monitoring and the measurement of basal and stimulated serum c alcitonin are subsequently performed. Radiotherapy and chemotherapy play a marginal role in advanced MTC. Recently, it has been found that somatostati n analogs and type I interferon are able to control the neuroendocrine symp toms induced by advanced MTC and that they provide clinical benefit by impr oving the lifestyle of these patients. CONCLUSION, Although these agents are poorly active in inducing a shrinkage in tumor mass, the combined use of different biologic agents and cytotoxic drugs needs to be explored in advanced MTC. However, at present, surgery i s the only curative treatment for MTC. (C) 2001 American Cancer Society.