title: Metronomic chemotherapy in anaplastic thyroid carcinoma: a potentially feasible alternative to therapeutic nihilism.
abstract: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies and prognostic outlook remains very dismal. Treatment most often is palliative in intent attempting to relieve the patients from local compressive symptoms in the neck. Radical surgery, radiotherapy (RT), and chemotherapy have not been tested in large prospective trials, and current evidence from retrospective series and small trials indicate only marginal survival benefits. Given the poor prognostic and therapeutic outlook, patients must be encouraged to be actively involved in the decision making process. We report the case of an elderly patient who had no response to palliative RT, and was treated with oral metronomic chemotherapy. The response to oral metronomic chemotherapy was dramatic, and the patient has enjoyed complete freedom from symptoms as well as radiologically exhibits a complete regression. Thus, we document the first ever use of a simple, cost-effective, and convenient oral metronomic chemotherapeutic regimen delivering a remarkable response in an elderly patient with ATC.
authors.affiliation: Department of Radiotherapy, Government Medical College, Haldwani, Nainital, Uttarakhand, India.
authors.forename: Swaroop
authors.initials: S
authors.lastname: Revannasiddaiah
authors.affiliation: Department of Medical and Pediatric Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.
authors.forename: Irappa
authors.initials: I
authors.lastname: Madabhavi
authors.affiliation: Department of Pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Bodh
authors.affiliation: Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Thakur
authors.affiliation: Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Sharma
keywords: Anaplastic carcinoma thyroid; Anaplastic thyroid cancer; Metronomic chemotherapy; Metronomic cyclophosphamide; Therapeutic nihilism