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Current approaches and perspectives in the therapy of medullary thyroid carcinoma
Author(s) -
Vitale Giovanni,
Caraglia Michele,
Ciccarelli Antonio,
Lupoli Gelsy,
Abbruzzese Alberto,
Tagliaferri Pierosandro,
Lupoli Giovanni
Publication year - 2001
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20010501)91:9<1797::aid-cncr1199>3.0.co;2-p
Subject(s) - medicine , calcitonin , medullary thyroid cancer , radiation therapy , chemotherapy , thyroid carcinoma , thyroidectomy , thyroid cancer , oncology , medullary carcinoma , somatostatin , thyroid
BACKGROUND Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor derived from parafollicular cells. At present, surgery is the most important treatment for MTC. METHODS We describe the current approaches of MTC treatment (surgery, chemotherapy, radiation therapy, and biologic therapy). RESULTS MTC is currently approached surgically in the main part through total thyroidectomy and compartment‐oriented microdissection of cervicomediastinal lymph nodes. Substitutive l‐thyroxine administration together with close clinical monitoring and the measurement of basal and stimulated serum calcitonin are subsequently performed. Radiotherapy and chemotherapy play a marginal role in advanced MTC. Recently, it has been found that somatostatin analogs and type I interferon are able to control the neuroendocrine symptoms induced by advanced MTC and that they provide clinical benefit by improving the lifestyle of these patients. CONCLUSION Although these agents are poorly active in inducing a shrinkage in tumor mass, the combined use of different biologic agents and cytotoxic drugs needs to be explored in advanced MTC. However, at present, surgery is the only curative treatment for MTC. Cancer 2001;91:1797–808. © 2001 American Cancer Society.