Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer

Biermann, Martin; Pixberg, Michaela; Riemann, Burkhard; Schuck, Andreas; Heinecke, Achim; Schmid, Kurt Werner; Willich, Normann; Dralle, Henning; Schober, Otmar

doi:10.3413/nukmed-0221

Cited by 69 publications

(24 citation statements)

References 24 publications

(35 reference statements)

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“…The MSDS trial represents the largest multi-institutional cohort of high-risk patients with differentiated thyroid cancer patients worldwide second to the North American National Thyroid Cancer Treatment Cooperative Study (12,16,17). Inclusion criteria were PTC and FTC with extrathyroidal extension and without known distant metastases at the time of primary diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…and 70 years (excl.) at the time of initial surgery, completion of primary surgical therapy with R0-or R1-resection, Karnofsky index R70% and freedom from distant metastases at the time of initial radioiodine therapy (10)(11)(12). Exclusion criteria were poorly differentiated (insular) thyroid carcinoma, secondary cancer and R2-resection with macroscopic tumour residues.…”

Section: Patientsmentioning

confidence: 99%

“…131 I whole body scan, cervical ultrasound and serum Tg under endogenous or exogenous recombinant TSH stimulation were performed 3 months and 1 year after the last ablative radioiodine therapy and thereafter at 2-year intervals. Out-patient follow-up visits were scheduled at half-year intervals (12). Owing to a recruitment deficit for radiotherapy, the randomisation arm was closed in 2003, and the trial was continued as a prospective multicentre study.…”

Section: Patientsmentioning

confidence: 99%

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Primary tumour size is a prognostic parameter in patients suffering from differentiated thyroid carcinoma with extrathyroidal growth: results of the MSDS trial

Krämer¹,

Schmid²,

Dralle³

et al. 2010

European Journal of Endocrinology

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Objective: The Multicentre Study Differentiated Thyroid Cancer (MSDS) collective represents a well-defined group of patients with thyroid carcinomas with extrathyroidal extension. The aim of the present study was to evaluate the relationship of the primary tumour size with clinicopathological features as well as the outcome of patients with minimum and extensive extrathyroidal growth (pT3b-and pT4a-tumours; UICC 2002/2003, 6th ed). Methods: The tumour diameter was available in 324 out of 351 MSDS patients (244 females, 80 males). Mean age of patients was 47.7G12.0 years (range, 20.1-69.8 years), and the median follow-up was 6.2 years. The relationship between primary tumour size and the following clinicopathological data was investigated: age, gender, histological tumour type (papillary thyroid carcinomas (PTC) versus follicular thyroid carcinomas (FTC)) and UICC/AJCC TNM classification. In addition, the correlation between primary tumour size and event-free and overall survival was assessed. Results: The FTC of our series were significantly larger than PTC (3.46 vs 1.84 cm; P!0.001). Patients suffering from pT3b-tumours presented with significantly smaller tumour size than those with extensive extrathyroidal growth (pT4a-tumours) (1.9 vs 3.0 cm; P!0.01). All patients with distant metastases suffered from tumours O2 cm. Furthermore, event-free and overall survival were significantly correlated with increasing tumour size (P!0.05). Using multivariate analysis, a pT4a-category and a tumour diameter O2 cm remained independent predictors of survival. Conclusions: In patients suffering from differentiated thyroid carcinoma with extrathyroidal growth (pT3b and pT4a), the tumour size is an independent predictor of event-free and overall survival.

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Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

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Primary tumour size is a prognostic parameter in patients suffering from differentiated thyroid carcinoma with extrathyroidal growth: results of the MSDS trial

Krämer¹,

Schmid²,

Dralle³

et al. 2010

European Journal of Endocrinology

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“…A single randomized prospective trial in Germany failed to recruit adequate patients and only 26 received EBRT. 1 However, a mounting number of retrospective studies have been reported, including several recent studies showing significant benefit for EBRT in select patients. 2–4 The Endocrine Surgery Committee of the American Head and Neck Society (AHNS) here provides recommendations regarding the use of EBRT for locoregional control in DTC, based on review of the literature and expert opinion of the authors.…”

Section: Introductionmentioning

confidence: 99%

External‐beam radiotherapy for differentiated thyroid cancer locoregional control: A statement of the American Head and Neck Society

Kiess¹,

Agrawal²,

Brierley

et al. 2015

Head & Neck

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The use of external-beam radiotherapy (EBRT) in differentiated thyroid cancer (DTC) is debated because of a lack of prospective clinical data, but recent retrospective studies have reported benefits in selected patients. The Endocrine Surgery Committee of the American Head and Neck Society provides 4 recommendations regarding EBRT for locoregional control in DTC, based on review of literature and expert opinion of the authors. (1) EBRT is recommended for patients with gross residual or unresectable locoregional disease, except for patients <45 years old with limited gross disease that is radioactive iodine (RAI)-avid. (2) EBRT should not be routinely used as adjuvant therapy after complete resection of gross disease. (3) After complete resection, EBRT may be considered in select patients >45 years old with high likelihood of microscopic residual disease and low likelihood of responding to RAI. (4) Cervical lymph node involvement alone should not be an indication for adjuvant EBRT.

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“…No prospective trials have been performed, and a recent German study designed to address this issue was closed because only 45 of 311 patients recruited agreed to randomization (60).…”

Section: Adjuvant Therapiesmentioning

confidence: 99%

Management of Invasive Differentiated Thyroid Cancer

Nixon

Simó

Newbold

et al. 2016

Thyroid

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Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer

Abstract: The MSDS trial showed low mortality and recurrence rates and a weak benefit of RTx in terms of local control that did however not reach statistical significance. Routine RTx in locally invasive DTC can no longer be recommended.

Cited by 69 publications

References 24 publications

Primary tumour size is a prognostic parameter in patients suffering from differentiated thyroid carcinoma with extrathyroidal growth: results of the MSDS trial

Primary tumour size is a prognostic parameter in patients suffering from differentiated thyroid carcinoma with extrathyroidal growth: results of the MSDS trial

External‐beam radiotherapy for differentiated thyroid cancer locoregional control: A statement of the American Head and Neck Society

Management of Invasive Differentiated Thyroid Cancer

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