title: Concurrent doxorubicin and radiotherapy for anaplastic thyroid cancer: a critical re-evaluation including uniform pathologic review.
abstract: OBJECTIVE
  Anaplastic thyroid carcinoma (ATC) is a rare, aggressive malignancy. The potential for pathologic misclassification complicates interpretation of published data. One standard treatment option for locoregionally advanced disease is weekly low-dose doxorubicin with concurrent radiation therapy, and was previously developed at our institution. We evaluated our more recent experience with this approach, which included pathologic confirmation of all cases.
  
  
  METHODS
  A retrospective review was performed on patients identified through the Memorial Sloan-Kettering Cancer Center (MSKCC) Cancer Database.
  
  
  METHODS
  pathologically confirmed ATC; locoregional disease encompassable within a radiation portal; treatment with curative intent at MSKCC with planned weekly doxorubicin (10 mg/m(2)) and concurrent radiation. Principle outcomes assessed were locoregional progression-free survival (LR-PFS) and overall survival (OS).
  
  
  RESULTS
  Thirty-seven patients were included. Median radiotherapy dose was 57.6 Gy, and was ≥ 50Gy in 29 (78%), administered through hyperfractionated or once-daily schedules. One-year outcomes were LR-PFS, 45%; OS, 28%.
  
  
  CONCLUSIONS
  The prognosis of patients with ATC remains grim and our current results appear inferior to those reported previously by our institution. More accurate histologic diagnoses and patient selection in the present series compared to the prior one may be responsible in part. Better therapy is desperately needed for this aggressive disease.
authors: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, United States. shermane@mskcc.org
authors: Eric J
authors: EJ
authors: Sherman
authors: Su Hsien
authors: SH
authors: Lim
authors: Alan L
authors: AL
authors: Ho
authors: Ronald A
authors: RA
authors: Ghossein
authors: Matthew G
authors: MG
authors: Fury
authors: Ashok R
authors: AR
authors: Shaha
authors: Michael
authors: M
authors: Rivera
authors: Oscar
authors: O
authors: Lin
authors: Suzanne
authors: S
authors: Wolden
authors: Nancy Y
authors: NY
authors: Lee
authors: David G
authors: DG
authors: Pfister
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D065646:Thyroid Carcinoma, Anaplastic; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin