Role of external beam radiotherapy in patients with advanced or recurrent nonanaplastic thyroid cancer: Memorial Sloan-Kettering Cancer Center experience Journal Article
| Authors: | Terezakis, S. A.; Lee, K. S.; Ghossein, R. A.; Rivera, M.; Tuttle, R. M.; Wolden, S. L.; Zelefsky, M. J.; Wong, R. J.; Patel, S. G.; Pfister, D. G.; Shaha, A. R.; Lee, N. Y. |
| Article Title: | Role of external beam radiotherapy in patients with advanced or recurrent nonanaplastic thyroid cancer: Memorial Sloan-Kettering Cancer Center experience |
| Abstract: | Purpose: External beam radiotherapy (EBRT) plays a controversial role in the management of nonanaplastic thyroid cancer. We reviewed our institution's outcomes in patients treated with EBRT for advanced or recurrent nonanaplastic thyroid cancer. Methods and Materials: Between April 1989 and April 2006, 76 patients with nonanaplastic thyroid cancer were treated with EBRT. The median follow-up for the surviving patients was 35.3 months (range, 4.2-178.4). The lesions were primarily advanced and included Stage T2 in 5 (7%), T3 in 5 (7%), and T4 in 64 (84%) patients. Stage N1 disease was present in 60 patients (79%). Distant metastases before EBRT were identified in 27 patients (36%). The median total EBRT dose delivered was 6,300 cGy. The histologic features examined included medullary in 12 patients (16%) and nonmedullary in 64 (84%). Of the 76 patients, 71 (93%) had undergone surgery before RT, and radioactive iodine treatment was used in 56 patients (74%). Results: The 2- and 4-year overall locoregional control rate for all histologic types was 86% and 72%, respectively, and the 2- and 4-year overall survival rate for all patients was 74% and 55%, respectively. No significant differences were found in locoregional control, overall survival, or distant metastases-free survival for patients with complete resection, microscopic residual disease, or gross residual disease. Grade 3 acute mucositis and dysphagia occurred in 14 (18%) and 24 (32%) patients, respectively. Late adverse toxicity was notable for percutaneous endoscopic gastrostomy tube use in 4 patients (5%). Conclusion: The results of our study have shown that EBRT is effective for locoregional control of selected locally advanced or recurrent nonanaplastic thyroid malignancies, with acceptable acute toxicity. © 2009 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer chemotherapy; human tissue; aged; middle aged; cancer surgery; retrospective studies; major clinical study; overall survival; fatigue; intensity modulated radiation therapy; radiation dose; cancer staging; outcome assessment; recurrent cancer; follow up; antineoplastic agent; neoplasm recurrence, local; mucosa inflammation; radiotherapy dosage; radiotherapy; carcinoma, papillary; steroid; patient monitoring; pathology; medical record review; retrospective study; histology; distant metastasis; dysphagia; radioactive iodine; neoplasm, residual; imrt; intensity-modulated radiotherapy; physical therapy; tumor burden; taste disorder; xerostomia; cancer care facilities; new york city; thyroid cancer; thyroid neoplasms; dermatitis; external beam radiotherapy; cancer control; toxicity; disease control; analysis of variance; thyroid; carcinoma, medullary; head-and-neck cancer; nonanaplastic; iodine; hoarseness; steroid therapy; superior cava vein syndrome |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 73 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2009-01-01 |
| Start Page: | 795 |
| End Page: | 801 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2008.05.012 |
| PROVIDER: | scopus |
| PUBMED: | 18676097 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 11" - "Export Date: 30 November 2010" - "CODEN: IOBPD" - "Source: Scopus" |
