Chemotherapy of differentiated papillary or follicular thyroid carcinoma

Abstract

Chemotherapy is used as a palliative measure in 25% of recurrent inoperable or metastatic papillary, follicular, or mixed thyroid cancers that do not concentrate 131I. Doxorubicin, bleomycin, and cisplatin have been the principal agents employed. As advanced thyroid cancer is rare, there are few meaningful clinical trials that compare singleand multi-agent chemotherapy for differences in efficacy and toxicity. The Eastern Cooperative Oncology Group (ECOG) designed and completed the only randomized study of doxorubicin vs doxorubicin plus cisplatin in inoperable, radioiodine-resistant advanced thyroid cancer in chemotherapy-naive patients. In this study reported in 1985 (1), 41 patients received doxorubicin alone, and 43 patients received the combination. There were 16 patients with differentiated thyroid cancers who received single-agent doxorubicin, given at a dose of 60 mg/m2 intravenously every 3 wk. A total of 19 comparable patients received the combination of doxorubicin at 60 mg/m2 and cisplatin at 40 mg/m2 every 3 wk. Treatment was discontinued when stable disease was achieved after three cycles of therapy, when disease progressed after two treatment cycles, or when the total dose of doxorubicin exceeded 550 mg/m2. © 2006 Humana Press Inc.