Abstract
Aim To evaluate an efficacy of various chemotherapeutical combination in treatment of advanced medullary thyroid cancer (MTC). Materials and methods From 2001 to 2002 year 7 patients with advanced MTC were treated with chemotherapy. Mean age was 42 years (range 22–62). Mean fallow-up mean period was 16 months. Scheme ZDF, 3 patients, included Zavedos 5 mg/m 2 i/v 1 – 3 day; Dacarbozine mg/m 2 i/v 1–3 day; 5-Flourouracil 250 mg/m 2 i/v permanent infusion during 3 days. Scheme HC, 3 patients, Holoxan 2.5 mg/m 2 i/v 1 ? 5 days and Cisplatinum 100 mg/m 2 i/v ? 1st day. Scheme VG, 1 patient, daily infusions of Vinorelbine 30 mg/m 2 on 1st day and Gemzar 1500 mg/m 2 on 8th. Schemes repeated every 3, three courses. Effectiveness was assessed correspondingly to WHO criteria (Geneva, 1979). Results All six patients who underwent ZDF and HC combinations displayed positive response. Partial regression registered in two patients for each combination and stabilization in another one. Mean positive effect duration was 6 months in ZDF group and 12 months in HC group. In single patient who underwent VG combination was registered tumor progression. Tumor markers dynamics (TCT, CEA) during treatment did not reflect tumor response. All chemotherapy combinations were associated with nausea and vomiting which successfully treated with antiemetic drugs. ZDF scheme always was associated with dermatitis and phlebitis, and stomatitis in one case. HC scheme caused neutropenia and trombocytopenia in all patients. Conclusions Positive response was observed in all six cases following usage of ZDF and HC combinations. Partial response registered in two of three cases in each group and stabilization in others. Both combinations should be recommended for palliative treatment of MTC patients. HC combination was slightly more effective as well as more toxic. Taking into consideration a high rate of inoperable cases and unfourable behavior of MTC it is essential to continue evaluation and search of new effective schemes of chemotherapy.
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