title: Neoadjuvant chemotherapy in 16 patients with locally advanced papillary thyroid carcinoma.
abstract: BACKGROUND
  It is believed that chemotherapy (ChT) is ineffective in papillary thyroid carcinoma (PTC). The aim of our retrospective chart review was to find out if neoadjuvant ChT before thyroid surgery had any effect on the size of primary tumors in patients with PTC.
  
  
  METHODS
  The study included 16 patients (13 women, 3 men; median age 63.5 years) with PTC, who were treated with neoadjuvant ChT from 1988 to 2005. Poorly differentiated PTC, classical PTC, a follicular variant of PTC, and a Hürthle cell variant of PTC were diagnosed in 5, 5, 3, and 3 cases, respectively. The mean tumor diameter was 9.67 cm. Seven patients had a pT4 tumor. Regional and distant metastases were detected in 10 and 7 patients, respectively. ChT consisted of vinblastine in 11 cases, vinblastine with adriamycin in 2 cases, and other schedules in 3 cases. Four patients were also treated with preoperative external irradiation.
  
  
  RESULTS
  Altogether, 40 cycles of ChT were given. After ChT, the tumor size decreased in all 16 patients: by >50% in 7 (44%) patients and by <50% in 9 patients. R0, R1, and R2 resection was performed in 2, 10, and 4 cases, respectively. The median survival time of our patients was 88 months. Six patients are still alive; two died of causes not related to carcinoma, while eight patients died of PTC.
  
  
  CONCLUSIONS
  Neoadjuvant ChT before thyroid surgery may be effective in patients with locally advanced PTC. After neoadjuvant ChT, in 44% of patients, the tumor size decreased by >50%.
authors.affiliation: Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia. nbesic@onko-i.si
authors.forename: Nikola
authors.initials: N
authors.lastname: Besic
authors.forename: Marija
authors.initials: M
authors.lastname: Auersperg
authors.forename: Marta
authors.initials: M
authors.lastname: Dremelj
authors.forename: Barbara
authors.initials: B
authors.lastname: Vidergar-Kralj
authors.forename: Barbara
authors.initials: B
authors.lastname: Gazic
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002291:Carcinoma, Papillary; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014747:Vinblastine; D004317:Doxorubicin