title: Long-term results of radiotherapy in anaplastic thyroid cancer.
abstract: BACKGROUND
  Anaplastic thyroid cancer (ATC) is an aggressive malignant tumour with a poor prognosis. The median overall survival is described in the literature to be just 6 months, however, in series of selected patients treated by multimodal therapy cases of long-time-survival have been reported. We analyzed the role of radiotherapy and the impact of other therapies and clinical features on survival in patients with ATC.
  
  
  METHODS
  In a retrospective analysis of all patients (n = 40), who presented with histologically proven ATC at a single centre between 1989 and 2008, patient and treatment characteristics with a focus on details of radiotherapy were registered and the survival status determined.
  
  
  RESULTS
  39 of 40 patients received radiotherapy, 80% underwent surgery and 15% had chemotherapy. The median dosis of radiation was 50 Gy (6-60.4 Gy), in 87.5% fractionation was once daily. In 49.4% opposing-field techniques were applied, in 14% 3D-conformal-techniques and 32.5% combinations of both.The median overall survival (OS) was 5 months, 1-year survival 35.2% and 5-year-survival 21.6%. Interestingly, 24.3% survived 2 years or longer. Three factors could be identified as predictors of improved overall survival: absence of lymph node metastasis (N0) (median OS 18.3 months), median dose of radiation of 50 Gy or more (median OS 10.5 months) and the use of any surgery (median OS 10.5 months).
  
  
  CONCLUSIONS
  Despite the generally poor outcome, the combination of surgery and intensive radiotherapy can result in long-term survival in selected patients with ATC.
authors.forename: Anne-Katrin
authors.initials: AK
authors.lastname: Dumke
authors.forename: Tanja
authors.initials: T
authors.lastname: Pelz
authors.affiliation: Department of Radiation Oncology, Martin Luther University Halle-Wittenberg, Dryanderstr, 4, 06110 Halle (Saale), Germany. dirk.vordermark@uk-halle.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods*; D012189:Retrospective Studies; D065646:Thyroid Carcinoma, Anaplastic / Q000401:mortality* / Q000532:radiotherapy*; D013997:Time Factors; D016896:Treatment Outcome