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The Scientific World Journal
Volume 2014 (2014), Article ID 674583, 8 pages
http://dx.doi.org/10.1155/2014/674583
Research Article

Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature

1Head and Neck Surgery, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
2Head and Neck Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
3Head and Neck Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK

Received 23 August 2013; Accepted 11 September 2013; Published 17 February 2014

Academic Editors: H.-J. Biersack, H. J. Gallowitsch, and H. Zitzelsberger

Copyright © 2014 Natalie M. Lowe et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Anaplastic thyroid carcinoma (ATC) is rare yet accounts for up to 50% of all thyroid cancer deaths. This study reviews outcomes of patients with confirmed ATC referred to a tertiary oncology centre plus reviews the literature to explore how poor outcomes may be improved. Materials and Methods. The management and outcomes of 20 patients with ATC were reviewed. Results. Median age at diagnosis was 69.5 years. 19 patients died due to ATC, 40% of whom died from asphyxiation. Median survival for all cases was 59 days. Patients who had previous surgery prior to other treatment modalities had a longer median survival overall compared to those who had not had previous surgery (142 days compared to 59 days) and produced the one long-term survivor. Chemotherapy followed by radiotherapy (without previous surgery) was associated with longer median survival (220 days). Palliative radiotherapy alone did not decrease the rate of death by asphyxiation when compared to other single modality treatments. Conclusion. Multimodality treatment including surgery when feasible remains the best strategy to improve survival and prevent death from asphyxiation in the management of ATC. The addition of chemotherapy to our institutional protocol led to improved survival but prognosis remains very poor.