title: Neoadjuvant chemotherapy in 13 patients with locally advanced poorly differentiated thyroid carcinoma based on Turin proposal - a single institution experience.
abstract: BACKGROUND
  There is a paradigm that chemotherapy is ineffective in thyroid carcinoma. The aim of our study was to find out whether neoadjuvant chemotherapy before thyroid surgery had an effect on the size of primary tumour in patients with poorly differentiated thyroid carcinoma (PDTC) based on Turin proposal.
  
  
  METHODS
  Altogether, 13 patients (8 women, 5 men; median age 61 years) with PDTC based on Turin proposal were treated with neoadjuvant chemotherapy between 1986 and 2005. Tumour diameter was from 4.5 to 18 cm (median 9 cm). Regional and distant metastases were detected in 6 and 9 patients, respectively. Eight patients had pT4 tumour.
  
  
  RESULTS
  Altogether, 29 (range 1-5) cycles of chemotherapy were given. Tumour diameter decreased in all the patients and by more than 30% in 5 patients (= 38%). Two of these five patients had also preoperative external beam irradiation (EBRT). Total thyroidectomy, lobectomy and neck dissection were performed in 10, 3 and 5 cases, respectively. R0 and R1 resection was done in 5 and 8 cases, respectively. Eight patients had postoperative EBRT of the neck and upper mediastinum. The 5-year and 10-year cause-specific survival rates of patients were 66% and 20%, respectively.
  
  
  CONCLUSIONS
  After neoadjuvant chemotherapy a partial tumour regression was observed in 38% of patients with PDTC based on Turin proposal.
authors.affiliation: Department of Surgery.
authors.forename: Nikola
authors.initials: N
authors.lastname: Besic
authors.affiliation: Department of Radiotherapy.
authors.forename: Marta
authors.initials: M
authors.lastname: Dremelj
authors.affiliation: Department of Nuclear Medicine.
authors.forename: Andreja
authors.initials: A
authors.lastname: Schwartzbartl-Pevec
authors.affiliation: Department of Pathology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gazic
keywords: chemotherapy; neoadjuvant; pathology; poorly differentiated thyroid carcinoma; survival