XXXX and Survival in Anaplastic Thyroid Carcinoma.

@entity1 @entity632 @entity66 @entity146 @entity5 @entity1311 @entity3 @entity2867 @entity1374
Importance: @entity2867 is an undifferentiated @entity146 with a high rate of regional and distant spread and a grave prognosis (median survival, 3 months) with no standardized treatment. Objective: To review the effect of an active treatment policy on the outcome of @entity2867 . Design, Setting, and @entity1 : Retrospective comparative study of all @entity1 diagnosed as having @entity2867 and undergoing treatment from January 1, 2008, through December 31, 2013, in a tertiary university-affiliated medical center. Data were collected by medical record review. Final follow-up was completed on November 30, 2014. Data were analyzed from December 1 to 3, 2014. Interventions: Treatment options included surgery and adjuvant concomitant radiotherapy and chemotherapy with @entity632 or @entity1311 for @entity66 ; full-dose chemoradiotherapy (70 Gy to the gross @entity5 ) for @entity66 when surgery was not feasible; aggressive palliative radiotherapy (50 Gy to the gross @entity5 ) for @entity3 ; and palliative radiotherapy ( <=30 Gy) for @entity3 with a low performance status. Main Outcomes and Measures: Survival time and quality of life. Results: Of the 26 @entity1 (including 15 @entity1 ) who met the inclusion criteria, 11 underwent radiotherapy with curative intent. These @entity1 included 5 who underwent curative surgery (5 with chemotherapy) and 6 who received primary chemotherapy. Nine @entity1 received aggressive palliative radiotherapy, and 3 received palliative radiotherapy. The remaining 3 @entity1 were not treated. Curative radiotherapy was associated with a significantly longer overall median (95% CI) survival time (11 [8.1-13.9] months) than aggressive palliative radiotherapy (6 [3.1-8.9] months), palliative radiotherapy (3 [0.0-7.8] months), and no treatment (1 month) (P   <   .001). Chemotherapy in 10 @entity1 had a significant effect on survival (mean [95% CI], 11 [1.2-6.8] vs 4 [8.1-13.9] months for @entity1 who did not receive chemotherapy; P   =   .01). Among the @entity1 who underwent surgery and curative radiotherapy, 3 were alive after more than 3 years of follow-up. No association of survival with @entity1 sex (median [95% CI] survival for @entity1 and @entity1 , 9 [3.6-14.4] and 5 [0.3-9.7] months, respectively; P   =   .54) or a history of @entity1374 (median [95% CI] survival for those with and without, 4 [1.0-6.9] and 9 [5.4-12.5] months, respectively; P   =   .15) was found. Conclusions and Relevance: @entity2867 has a grave prognosis, but an aggressive approach, including surgery, chemotherapy, and radiotherapy, seems to improve survival. Higher doses of radiotherapy may have a survival benefit in candidates for palliative treatment and may be considered for @entity1 with @entity66 .
