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Treatment of Medullary Thyroid Carcinoma
Treatment of Local Recurrences and Distant Metastases
The primary treatment modality for patients who develop local or regional recurrence of MTC is surgery to remove the recurrent tumor. If, 2 to 3 months after surgery, the serum levels of calcitonin and carcinoembryonic antigen remain elevated, external-beam radiation therapy to the neck and mediastinum is also usually performed.
The treatment of MTC that has metastasized to distant sites involves:
- Relief of symptoms such as diarrhea and pain with medications
- Surgery may be used to treat single metastasis to the lungs, liver, or bone
- External-beam radiation therapy is often used to treat bone or brain metastases that cannot be removed by surgical excision
- Chemotherapy - Chemotherapy is not a standard treatment for metastatic MTC because response rates are usually low (approximately 20%) and studies have shown no benefits in terms of survival for patients treated with various combinations of chemotherapeutic agents. Chemotherapy is usually reserved for a limited number of patients with rapidly progressive metastatic disease, preferably in the context of clinical trials.
