Therapy of Stage IV B Anaplastic Thyroid Carcinoma: Single Institution Experience

Purpose: To evaluate the efficacy of radiotherapy and chemotherapy in stage IV B anaplastic thyroid carcinoma (ATC).

Patients And Methods: From 1997 to 2007, 16 inoperable patients (12 females, 4 males, median age 60 years, range 27-71) with pathologically confirmed ATC without distant metastases (UICC stage IV B) were treated with radiotherapy and chemotherapy at our Institution. Five patients had Eastern Cooperative Oncology Group (ECOG) performance status 1, and 11 ECOG 2. All patients received the planned radiotherapy tumor dose of 60 Gy. Radiotherapy was followed by chemotherapy with doxorubicin 60 mg/m(2) and cisplatin 40 mg/m(2) every 3 weeks. The primary study endpoint was response rate (RR) and secondary endpoints were toxicity and overall survival (OS).

Results: Only one patient achieved complete response (CR: 6.25%, 95% CI: 0-35) and 3 patients (18.75%, 95% CI: 4-46) partial response (PR), for an overall response rate (ORR) of 25% (95% CI: 7-55). No toxic deaths occurred and no grade 4 adverse events were registered after radiotherapy. Grade 4 toxicity was seen in 3 patients (18.75%, 95% CI: 4- 46) after chemotherapy. Mean patient OS was 12.33 months (95% CI: 9.09-15.56) and median OS 11.0 months (95% CI: 8.56-13.44).

Conclusion: Radiotherapy and chemotherapy of stage IV B anaplastic thyroid carcinoma are well tolerated. Although the clinical benefit was 50%, survival rates remain low with OS of no more than 2 years.