Struma maligna pp 107-113 | Cite as

Flow-cytophotometric DNA Measurements for Monitoring and Planning Chemotherapy in Anaplastic Thyroid Carcinoma

  • M. Auersperg
  • M. Us-Krašovec
  • N. Bešič
  • A. Pogačnik
  • K. Stanič
  • B. Jezeršek
Conference paper


Anaplastic thyroid carcinoma is an aggressive tumour uncontrollable by surgery and/or irradiation, whereas addition of chemotherapy resulted in some long term survivors. In a series of 76 patients with anaplastic thyroid carcinoma treated from 1973–87 at the Institute of Oncology Ljubljana the best survival (median 15 months) was obtained with a combination of chemotherapy, irradiation, followed by surgery. However, only 6 out of 53 patients (11%) with primarily inoperable tumours in whom treatment was started with chemotherapy and irradiation were rendered operable. Since 1988 flow-cytophotometric DNA measurements have been used for immediate evaluation of the effect of chemotherapy and planning of treatment in anaplastic thyroid carcinoma at the Institute of Oncology. The aim of this study was to evaluate whether monitoring of treatment by flow-cytophotometric DNA measurements improved results of treatment in those patients.

From 29 patients with anaplastic thyroid carcinoma treated from 1988–1991 in 20 treatment was started with chemotherapy and irradiation. Sequential flow-cytophotometric DNA measurements for evaluation of chemotherapy were performed in 19 patients. Fine-needle aspiration biopsies were performed before and sequentially after the application of cytostatic drugs. DNA measurements (mercury lamp cytophotometer PAS II PARTEC) and cytomorphological studies were conducted on fine needle aspiration biopsy samples. The results of flow-cytophotometric DNA measurements after single cytostatic drug were used for planning combined chemotherapy or chemotherapy and irradiation. Vinblastine or Cis-Platinum or Adriamycin or Novantron were used for perturbation of the tumour cell cycle. When DNA measurements showed an accumulation of cells in a particular phase of a cell cycle the next drug effective in that phase was used at the most appropriate time. Local tumour control was significantly better in the group of patients monitored with flow-cytophotometric DNA measurements. Of 20 pts in whom treatment was started with chemotherapy and irradiation there were 8 responders (3 CR and 5 PR). In the patients treated from 1973–87 there were only 11% responders to chemotherapy and irradiation in contrast with 8/20 (40%) in the present series (p < 0.05). Six of these patients are alive (6,8,10,22 and 31 months) after treatment. Introduction of sequential flow-cytophotometric DNA measurements and cytomorphological examination of fine-needle aspiration biopsy specimens make possible individually tailored treatment which results in significantly improved locoregional control and may contribute to prolonged survival in patients with anaplastic thyroid carcinoma.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aldinger KA, Samaan NA, Ibanez M, Hill S Jr (1987) Anaplastic carcinoma of the thyroid. A review of 84 cases of spindle and giant cell carcinoma of the thyroid. Cancer 41:2267–2275CrossRefGoogle Scholar
  2. 2.
    Auersperg M, Us-Krasovec M, Petric G, Pogacnik A, Besic N (1990) Results of combined modality treatment in poorly differentiated and anaplastic thyroid carcinoma. Wien Klin Wochenschr 102/9:267–270PubMedGoogle Scholar
  3. 3.
    Auersperg M, Zorc Pleskovic R, Us Krasovec M, Vraspir Porenta O (1987 DNA measurements and cytomorphology — a basis for planning chemotherapy in anaplastic giant — cell carcinoma of thyroid. Radiol Iugosl 21/1:47–53Google Scholar
  4. 4.
    De Besi P, Busnardo B, Toso S, Girelli ME, Nacamulli D, Simioni N, Casara D, Zorat P, Fiorentino MV (1991) Combined chemotherapy with bleomycin, adriamycin, and platinum in advanced thyroid cancer. J Endocrinol Invest 14:475–480PubMedGoogle Scholar
  5. 5.
    Gottlieb JA, Stratton Hill C jr (1975) Adriamycin (NSC-123127) therapy in thyroid carcinoma. Cancer Chemother Rep 6:283–296Google Scholar
  6. 6.
    Grdina DJ, Sigdestad CP, Peters LJ (1980) Cytotoxic effect in vivo of selected chemotherapeutic agents on synchronized murine fibrosarcoma cells. Br J Cancer 42:677–683PubMedCrossRefGoogle Scholar
  7. 7.
    Hemmer J, Kreidler J, Thein T, Haase S (1991) Monitoring of intra-arterial treatment with Epirubicin and Cisplatin in oral carcinoma by DNA flow-cytometry. Chemotherapy 37:150–156PubMedCrossRefGoogle Scholar
  8. 8.
    Kim JH, Leeper RD (1987) Treatment of locally advanced thyroid carcinoma with combination of Doxorubicin and radiation therapy. Cancer 60:2372–2375PubMedCrossRefGoogle Scholar
  9. 9.
    Ordonez NG, Hickey RC, Samaan NA (1987) Anaplastic thyroid carcinoma. Cancer Bull 39:318–323Google Scholar
  10. 10.
    Pimpl W, Rieger R, Winkler J, Boeckl O, Galvan G (1990) Wert der praeoperativen Feinnadelpunktionszytologie in der Diagnose hochmaligner Schilddrüsentumoren. Wien Klin Wochenschr 102/9:244–247PubMedGoogle Scholar
  11. 11.
    Schlumberger M, Parmentier C, Delisle MJ, Couette JE, Droz JP, Sarrazin D (1991) Combination therapy for anaplastic giant cell thyroid carcinoma. Cancer 67/3:564–566PubMedCrossRefGoogle Scholar
  12. 12.
    Shimaoka K, Schoenfeld DA, DeWys W, Creech RH, DeConti R (1985) A randomized trial of Doxorubicin versus Doxorubicin plus Cisplatin in patients with advanced thyroid carcinoma. Cancer 56:2155–2160PubMedCrossRefGoogle Scholar
  13. 13.
    Spyratos F, Briffod M, Tubiana-Hulin M, Andrieu C, Mayras C, Pallud C, Lasry S, Rouesse J (1982) Sequential cytopunctures during preoperative chemotherapy for breast carcinoma. Cancer 69:470–475CrossRefGoogle Scholar
  14. 14.
    Tallroth E, Wallin G, Lundell G, Löwhagen T, Einhorn J (1987) Multimodality treatment in anaplastic giant cell thyroid carcinoma. Cancer 60:1428–1431PubMedCrossRefGoogle Scholar
  15. 15.
    Venkatesh YSS, Ordonez NG, Schultz PN, Hickey RC, Goepferd H, Samaan NA (1990) Anaplastic carcinoma of the thyroid. A clinicopathologicn studyGoogle Scholar
  16. 16.
    Werner B, Abele J, Alveryd A et al. (1984) Multimodal therapy in anaplastic giant cell thyroid carcinoma. World J Surg 8:64–70PubMedCrossRefGoogle Scholar
  17. 17.
    Yoshida A, Fakazawa M, Aiyoshi Y, Soeda S, Ito K (1990) The biological characteristics and chemosensitivity of anaplastic thyroid carcinoma transplated into nude mice. Jpn J Surg 20:690–695PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • M. Auersperg
  • M. Us-Krašovec
  • N. Bešič
  • A. Pogačnik
  • K. Stanič
  • B. Jezeršek

There are no affiliations available

Personalised recommendations