Otolaryngology, Head and Neck Surgery, The Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin, Ireland.
Oral Oncol. 2013 Jul;49(7):702-6. doi: 10.1016/j.oraloncology.2013.03.440. Epub 2013 Apr 11.
Anaplastic thyroid cancer (ATC) is a lethal disease causing a global disproportionate number of thyroid cancer-related deaths. The American Thyroid Association (ATA) has recently produced clear and comprehensive guidelines to assist physicians treating ATC.
The recent ATA guideline publication was reviewed. A systematic review of studies indexed in Medline and Pubmed was also undertaken using search terms relevant to ATC.
Patients with ATC have a median survival of 5 months and less than 20% survive 1 year. Early tumor dissemination results in 20-50% percent of patients having distant metastases and 90% having adjacent tissue invasion on presentation. This highlights the necessity for effective combined therapy. Stage IVA/ IVB, resectable disease may benefit from a multimodal (surgery, IMRT for loco regional control, and systemic therapy) approach. However, a majority of patients present with unresectable locoregional disease. Early palliative care involvement is inclusive of life-prolonging therapies. ATC management demands rapid, complex and integrated multidisciplinary decision making.
In this article we discuss the multidisciplinary strategies that exist to optimize the management of these patients in accordance with the recent guidelines from The American Thyroid Association.
间变性甲状腺癌（ATC）是一种致命疾病，导致全球不成比例的甲状腺癌相关死亡。美国甲状腺协会（ATA）最近制定了明确而全面的指南，以帮助治疗 ATC 的医生。
回顾了最近的 ATA 指南出版物。还使用与 ATC 相关的搜索词，对 Medline 和 Pubmed 索引的研究进行了系统回顾。
ATC 患者的中位生存期为 5 个月，不到 20%的患者能存活 1 年。早期肿瘤播散导致 20-50%的患者出现远处转移，90%的患者在就诊时出现邻近组织侵犯。这凸显了有效联合治疗的必要性。IVA/IVB 期、可切除的疾病可能受益于多模式治疗（手术、局部区域控制的调强放疗和全身治疗）。然而，大多数患者的局部区域疾病无法切除。早期姑息治疗包括延长生命的治疗。ATC 管理需要快速、复杂和综合的多学科决策。
在本文中，我们根据美国甲状腺协会最近的指南，讨论了存在的多学科策略，以优化这些患者的管理。
