Combined Therapy for Undifferentiated Giant and Spindle Cell Carcinoma of the Thyroid

Abstract

Undifferentiated giant and spindle cell carcinoma is an unusual and high-grade malignant type of cancer of the thyroid. The results of surgical and/or radiotherapeutic treatment have been discouraging. Only a few patients respond to therapy, usually for a short time. Recently, a few reports have been published on the effect of chemotherapy or a combined treatment of surgery, radiotherapy and chemotherapy. In the present paper the results of combining radiotherapy and chemotherapy, 5-FU and cyclophosphamide, are reported. For the future a more aggressive approach is discussed. The therapy should include surgical resection of the main bulk of the tumour, followed by radiotherapy and concomitant chemotherapy and thereafter prolonged adjuvant chemotherapy. Acta Otolaryngol Downloaded from informahealthcare.com by Northwestern University on 12/27/14For personal use only.

Multimodal therapy in anaplastic giant cell thyroid carcinoma

“…In all cases the diagnosis was established by fine- needle aspiration biopsy [10,[12][13][14]. The aspirations were performed from different parts of the tumor.…”

“…A combination of radiotherapy and chemotherapy (5-fluorouracil and cyclophosphamide) given concomitantly has been reported to offer good local control [9,10]. Although most patients receiving such combination therapy nevertheless died, their deaths were usually caused by distant metastases rather than by local tumor growth.…”

Response of undifferentiated thyroid carcinoma to combined modality treatment

“…Nevertheless, histologic confirmation is essential, either by simple biopsy when total excision is impossible, as in our patient, or by examination of the thyroidectomy specimen. Anderson [8] was able to establish a correct diagnosis in all of his 8 patients by simple needle biopsy. Similar results have been reported by others [9,10], using aspiration cytology.…”

Anaplastic Thyroid Carcinoma: Doxorubicin, hyperfractionated radiotherapy and surgery

“…This regimen, adopted in 8 patients (20), arrested the local growth in 6, but finally all patients died of local failure. When debulking surgery was added to this regimen (6), 4 out of 5 patients achieved local control and died of disseminated disease.…”