title: High-risk thyroid cancer. Prolonged survival with early multimodality therapy.
abstract: Eleven patients with high-risk thyroid carcinoma of anaplastic or mixed anaplastic-differentiated histology were treated using an early multimodality approach. Patients were classified using the prognostic index for thyroid carcinoma developed by the EORTC. Therapy consisted of a four-drug chemotherapy combination, radioiodine (131I), and Bacille-Calmette-Guerin (BCG) immunotherapy. Treatment was designed to maximize effects against both anaplastic and differentiated tumor components. There has been prolonged disease-free survival (14+ to 73+ months) in patients with clear cell, small cell, and mixed anaplastic histologies. Currently five patients have been in complete remission for over 4 years. Treatment has been well tolerated. The long-term participation in care by a multispecialty team has produced promising results which we hope can be valuable as a basis for multicenter trials.
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012306:Risk; D013964:Thyroid Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*