Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, United States.
Radiother Oncol. 2011 Dec;101(3):425-30. doi: 10.1016/j.radonc.2011.09.004. Epub 2011 Oct 6.
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.
A retrospective review was performed on patients identified through the Memorial Sloan-Kettering Cancer Center (MSKCC) Cancer Database.
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).
Thirty-seven patients were included. Median radiotherapy dose was 57.6 Gy, and was ≥ 50Gy in 29 (78%), administered through hyperfractionated or once-daily schedules. One-year outcomes were LR-PFS, 45%; OS, 28%.
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.
间变性甲状腺癌（ATC）是一种罕见的侵袭性恶性肿瘤。病理误诊的可能性使发表数据的解读变得复杂。局部晚期疾病的一种标准治疗选择是每周低剂量阿霉素联合放射治疗，这是我们机构之前开发的方法。我们评估了使用这种方法的最新经验，其中包括所有病例的病理确认。
通过纪念斯隆-凯特琳癌症中心（MSKCC）癌症数据库对患者进行回顾性分析。
经病理证实的 ATC；局部区域疾病可包含在放射治疗范围内；在 MSKCC 接受根治性治疗，计划每周给予阿霉素（10mg/m²）和同步放疗。主要评估的结果是局部区域无进展生存期（LR-PFS）和总生存期（OS）。
共纳入 37 例患者。中位放疗剂量为 57.6Gy，29 例（78%）接受≥50Gy 放疗，采用超分割或每日一次方案。一年的结果是 LR-PFS 为 45%，OS 为 28%。
ATC 患者的预后仍然很严峻，我们目前的结果似乎不如我们机构以前报告的结果。与之前的研究相比，本研究中更准确的组织学诊断和患者选择可能在一定程度上是造成这种情况的原因。对于这种侵袭性疾病，迫切需要更好的治疗方法。
