18F-fluorodeoxyglucose positron emission tomography to assess response after radiation therapy in anaplastic thyroid cancer

Aggressive Palliation and Survival in Anaplastic Thyroid Carcinoma

“…The authors concluded that ATC has a poor prognosis regardless of the type of treatment. Levy et al 22 assessed the effect of radiotherapy with fludeoxyglucose F 18-labeled positron emission tomography. They reported higher rates of local recurrence in patients in whom the relative standardized uptake value (a marker of tumor response to treatment) decreased less than 20%.…”

Anaplastic Thyroid Carcinoma: An Update

“…Dedicated fast-track management of these patients may offer a better chance of tumor control, as early management is key according to good practice guidance for fast-growing cancers [ 2 , 62 ]. Although feasible in highly specialized tertiary centers, the applicability of this fast-track management approach in multiple tertiary centers at a whole-country level remains to be demonstrated, as exemplified by the huge differences in reported survival between nationwide ATC database analysis [ 4 , 5 , 16 ] in comparison with tertiary-center database analysis [ 14 , 62 , 63 , 64 ].…”

Radiation therapy dose is associated with improved survival for unresected anaplastic thyroid carcinoma: Outcomes from the National Cancer Data Base

“…Fit patients who present without sign of distant metastases are evaluated for surgery and adjuvant therapy to provide the best chance for a favorable outcome. However, because complete surgical resection is rarely feasible in ATC, radiation therapy (RT), often with concurrent chemotherapy, is considered in an attempt to induce local tumor regression (and achieve interim local control) and to avoid or delay local progression, preventing or deferring airway obstruction, severe dysphagia, and/or death secondary to overwhelming local tumor burden: scenarios that unfortunately are common in these patients despite prompt tracheostomy …”

“…However, because complete surgical resection is rarely feasible in ATC, radiation therapy (RT), often with concurrent chemotherapy, is considered in an attempt to induce local tumor regression (and achieve interim local control) and to avoid or delay local progression, preventing or deferring airway obstruction, severe dysphagia, and/or death secondary to overwhelming local tumor burden: scenarios that unfortunately are common in these patients despite prompt tracheostomy. [9][10][11][12][13] Because presentation with or development of subsequent distant metastases is also common, clinicians are faced with the challenge of how to prioritize local therapies and their intent or aggressiveness. [14][15][16] At our center, the presence of distant metastases does not necessarily preclude the use of upfront, locally palliative therapy to either treat or prevent impending symptoms or death from tracheal or esophageal compromise, because medically fit patients with smaller volume distant disease may still benefit from more durable local tumor control through the receipt of RT.…”