Adjuvant external beam radiotherapy for locally invasive papillary thyroid cancer

Megwalu, Uchechukwu C.; Orloff, Lisa A.; Ma, Yifei

doi:10.1002/hed.25639

Cited by 9 publications

(6 citation statements)

References 17 publications

(39 reference statements)

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“…Finally, the role of adjuvant cervical EBRT remains controversial [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Although this study includes the course of seven patients receiving adjuvant EBRT, only two (28.6%) of them took benefit of treatment in terms of cervical clearance of disease.…”

Section: Discussionmentioning

confidence: 99%

Radioiodine Refractory Follicular Thyroid Cancer and Surgery for Cervical Relapse

Chiapponi

Hartmann

Schmidt

et al. 2021

Cancers

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Compared to its more common counterpart papillary thyroid cancer (PTC), follicular thyroid cancer (FTC) has a less favorable outcome, due to its higher incidence of distant metastases and advanced stages at diagnosis. Despite radioiodine (RAI) avidity, metastatic FTC often progresses after radioiodine treatment (RAIT). We aimed at evaluating the indications and outcomes of surgery for cervical relapse of radioiodine refractory FTC. Patients receiving RAIT between 2005 and 2015 at the University Hospital of Cologne, Germany, were screened. Patients with FTC were identified. Demographics, clinic-pathologic characteristics, treatment, and outcome of patients diagnosed with RAI refractory FTC, who underwent cervical surgery in the course of disease, were analyzed. FTC accounted for 8.8% of all thyroid carcinomas undergoing RAIT. In 35.2% of FTC patients, disease persisted or recurred despite a cumulative mean RAI activity of 18.7 GBq ± 11.6 (follow-up 83.5 ± 56.7 months). Distant metastases were diagnosed in 75% of these patients, as bone (57.6%), lung (54.6%), and liver metastases (12.1%). Cervical relapse occurred in 63.6% of these patients and was treated in 57.1% with surgery with, and without, external beam radiation therapy (EBRT). Despite surgery and EBRT, in 75% of patients, cervical relapse recurred again. In conclusion, surgery for cervical radioiodine refractory FTC relapse is often performed in metastatic setting. With and without EBRT, cure is rare, although metastases can appear radioiodine avid. Early biological marker and systemic treatments for these patients are still needed.

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Section: Discussionmentioning

confidence: 99%

Radioiodine Refractory Follicular Thyroid Cancer and Surgery for Cervical Relapse

Chiapponi

Hartmann

Schmidt

et al. 2021

Cancers

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“…A 405-population-based study showed that, targeting well-differentiated thyroid cancers with pT4 stage, the 10- and 15-year OS rates were 85.7% and 77.1%, respectively, for the non-EBRT group and 67.5% and 57.0%, respectively, for the EBRT group (HR, 2.229; 95% CI 1.570–3.164; P < 0.0001) 19 . A study by Megwalu et al similarly confirmed that EBRT was associated with worse overall survival 20 . The reason for the difference in survival results may be related to the small sample size of previous studies, which was not sufficient to detect survival differences.…”

Section: Discussionmentioning

confidence: 83%

Prognostic value of adjuvant external beam radiotherapy for papillary thyroid cancer based on competitive risk model and propensity score matching

Zhou

Fan

et al. 2023

Sci Rep

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This study aimed to assess the impact of adjuvant external beam radiotherapy (EBRT) on the survival of patients with locally invasive papillary thyroid carcinoma. This retrospective study used data from the Surveillance, Epidemiology, and End Results database for the diagnosis of papillary thyroid carcinoma, using Cox models to screen for adverse prognostic factors. The prognostic value of using adjuvant external beam radiotherapy in papillary thyroid carcinoma was further evaluated, based on the competing risk model and propensity score matching. Based on the competitive risk model, the sub-distribution hazard ratio (SHR) of the multivariate analysis of patients receiving EBRT alone versus those receiving radioiodine-131 alone was 9.301 (95% CI 5.99–14.44) (P < 0.001), and the SHR of the univariate analysis was 1.97 (95% CI 1.03–3.78) (P = 0.042). In the propensity score-matched Kaplan–Meier analysis, patients who received EBRT still had worse OS (6-year OS, 59.62% vs 74.6%; P < 0.001) and DSS (6-year DSS, 66.6% vs 78.2%; P < 0.001) than patients who did not receive EBRT. Patients who received EBRT had a higher cumulative risk of death due to thyroid cancer after PSM (P < 0.001). Adjuvant EBRT was not associated with survival benefit in the initial management of locally invasive papillary thyroid cancer.

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“…A 405-population-based study showed that, targeting well-differentiated thyroid cancers with pT4 stage, the 10-and 15-year OS rates were 85.7% and 77.1%, respectively, for the non-EBRT group and 67.5% and 57.0%, respectively, for the EBRT group (HR, 2.229; 95% CI, 1.570-3.164; P < 0.0001) [19]. A study by Megwalu et al similarly con rmed that EBRT was associated with worse overall survival [20]. The reason for the difference in survival results may be related to the small sample size of previous studies, which was not su cient to detect survival differences.…”

Section: Discussionmentioning

confidence: 92%

Prognostic value of adjuvant external beam radiotherapy for papillary thyroid cancer based on competitive risk model and propensity score matching

Zhou

Fan

et al. 2022

Preprint

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Background: This study aimed to assess the impact of adjuvant external beam radiotherapy (EBRT) on the survival of patients with locally invasive papillary thyroid carcinoma. Methods: This retrospective study used data from the Surveillance, Epidemiology, and End Results database for the diagnosis of papillary thyroid carcinoma, using Cox models to screen for adverse prognostic factors. The prognostic value of using adjuvant external beam radiotherapy in papillary thyroid carcinoma was further evaluated, based on the competing risk model and propensity score matching. Results: Based on the competitive risk model, the sub-distribution hazard ratio (SHR) of the multivariate analysis of patients receiving EBRT alone versus those receiving radioiodine-131 alone was 9.301 (95% CI, 5.99–14.44) (P<0.001), and the SHR of the univariate analysis was 1.97 (95% CI, 1.03–3.78) (P=0.042). In the propensity score-matched Kaplan–Meier analysis, patients who received EBRT still had worse OS (6-year OS, 59.62% vs 74.6%; P<0.001) and DSS (6-year DSS, 66.6% vs. 78.2%; P<0.001) than patients who did not receive EBRT. Patients who received EBRT had a higher cumulative risk of death due to thyroid cancer after PSM (P<0.001). Conclusion: Adjuvant EBRT was not associated with survival benefit in the initial management of locally invasive papillary thyroid cancer.

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Adjuvant external beam radiotherapy for locally invasive papillary thyroid cancer

Cited by 9 publications

References 17 publications

Radioiodine Refractory Follicular Thyroid Cancer and Surgery for Cervical Relapse

Radioiodine Refractory Follicular Thyroid Cancer and Surgery for Cervical Relapse

Prognostic value of adjuvant external beam radiotherapy for papillary thyroid cancer based on competitive risk model and propensity score matching

Prognostic value of adjuvant external beam radiotherapy for papillary thyroid cancer based on competitive risk model and propensity score matching

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