External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer Journal Article


Authors: Romesser, P. B.; Sherman, E. J.; Shaha, A. R.; Lian, M.; Wong, R. J.; Sabra, M.; Rao, S. S.; Fagin, J. A.; Tuttle, R. M.; Lee, N. Y.
Article Title: External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer
Abstract: Background and Objectives: To review clinical outcomes and toxicities in locally advanced differentiated thyroid cancer patients treated with external beam radiotherapy (EBRT) with or without concurrent chemotherapy (CCRT). Methods: Between 1990 and 2012, 66 patients with gross residual/unresectable non-anaplastic non-medullary thyroid cancer were treated with EBRT. Results: The median overall survival was 42.0 months. The overall locoregional progression-free survival (LPFS) at 3 years was 77.3%. CCRT resulted in a non-significant improvement in LPFS (90.0% vs. 73.0%, P = 0.347). Poorly differentiated histology had significantly improved LPFS (89.4% vs. 66.1%, P = 0.020), despite a significantly worse distant metastasis-free survival (43.9% vs. 82.5%, P = 0.023). Acute treatment-related toxicity included dermatitis, mucositis, and dysphagia with grade three rates of 12.1%, 19.7%, and 16.7%, respectively. The incidence of late toxicity was low. CCRT was only associated with a significant greater rate of acute grade 3 hoarseness (10.0% vs. 0.0%, P = 0.033), but with no difference in the rate of grade 2 late toxicity. Conclusions: EBRT is a safe and effective treatment modality with 90% LPFS at 3 years in patients with gross residual or unresectable non-anaplastic, non-medullary thyroid carcinoma treated with CCRT. Further incorporation of EBRT with concurrent chemotherapy may result in improved disease control. © 2014 Wiley Periodicals, Inc.
Keywords: adult; cancer survival; treatment outcome; aged; major clinical study; overall survival; fatigue; cancer localization; cancer recurrence; cisplatin; doxorubicin; advanced cancer; cancer combination chemotherapy; paclitaxel; cancer radiotherapy; antineoplastic agent; disease association; progression free survival; etoposide; mucosa inflammation; nausea; vomiting; radiation injury; retrospective study; histology; dysphagia; imrt; xerostomia; radiation therapy; thyroid cancer; dermatitis; external beam radiotherapy; chemoradiation; hoarseness; institutional review; differentiated thyroid cancer; distant metastasis free survival; human; male; female; priority journal; article
Journal Title: Journal of Surgical Oncology
Volume: 110
Issue: 4
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2014-09-15
Start Page: 375
End Page: 382
Language: English
DOI: 10.1002/jso.23656
PROVIDER: scopus
PUBMED: 24961938
DOI/URL:
Notes: Export Date: 2 September 2014 -- CODEN: JSONA -- Source: Scopus
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MSK Authors
  1. James A Fagin
    180 Fagin
  2. Ashok R Shaha
    697 Shaha
  3. Robert M Tuttle
    481 Tuttle
  4. Eric J Sherman
    339 Sherman
  5. Nancy Y. Lee
    871 Lee
  6. Richard J Wong
    412 Wong
  7. Shyam S Rao
    83 Rao
  8. Mona M Sabra
    42 Sabra
  9. Ming Lian
    15 Lian
  10. Paul Bernard Romesser
    189 Romesser