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65

NCCN Guidelines for Patients

®

:

Thyroid Cancer, Version 1.2017

7

Treatment guide

Anaplastic thyroid cancer

Guide 24. Treatment by stage for anaplastic

Stage Treatment Next steps of care

Stage IVA

or IVB

ª

• Surgery

ª

• Adjuvant radiation

(EBRT/IMRT) with or

without chemotherapy

• Surgery not possible or

disease not able to be

completely removed

ª

• Radiation

(EBRT/IMRT)

with or without

chemotherapy

ª

• Consider

surgery–

depends on

response to

neoadjuvant

therapy

(treatment

before

surgery)

ª

Stage IVC

• Aggressive

therapy

ª

• Total

thyroidectomy

with lymph node

dissection, if

possible

• Radiation therapy

to local area

• Systemic therapy

• Consider a clinical

trial

ª

• Regular

imaging

of brain,

neck, chest,

abdomen, and

pelvis

• Consider FDG

PET/CT 3 to 6

months after

first therapy

ª

• Continue to

observe if no

disease

• Palliative

radiation to

local area

• Tumor

control (eg,

bone or

brain)

• Second-line

(next in line)

or clinical

trial

• See NCCN

Guidelines

for Palliative

Care

• Hospice

or best

supportive

care

• Palliative

care

(relieving

symptoms)

ª

• Palliative radiation

therapy to local

area

• Surgery or

radiation to control

tumor (eg, bone or

brain)

• See NCCN

Guidelines for

CNS Cancer

• Hospice or best

supportive care