Postoperative Simultaneous Integrated Boost-Intensity Modulated Radiation Therapy for Patients with Locoregionally Advanced Papillary Thyroid Carcinoma: Preliminary Results of a Phase II Trial and Propensity Score Analysis

Lee, Eun Kyung; Lee, You Jin; Jung, Yuh-S.; Ryu, Junsun; Kim, Tae Hyun; Lee, Chang Yoon; Ryu, Chang Hwan; Kim, Tae Sung; Kim, Seok Ki; Chung, Ki-Wook; Kim, Sang Soo; Kim, Dae Yong; Kim, Joo Young; Cho, Kwan Ho

doi:10.1210/jc.2014-3242

Cited by 18 publications

(24 citation statements)

References 34 publications

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“…Local control of PTC with extrathyroid invasion is very important for avoiding macroscopic residual cancer either in locoregional or in distant metastasis [ 19 ]. In a recent study, with the help of technical advances in radiotherapy planning, simultaneous integrated boost intensity modulated radiotherapy was performed in patients with locoregionally advanced papillary thyroid cancer [ 20 ]. Preliminary results showed the method proved effective in improving locoregional control in patients with locally advanced PTC.…”

Section: Discussionmentioning

confidence: 99%

Soft tissue invasion of papillary thyroid carcinoma

Lin

Chao

2016

Clin Exp Metastasis

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Extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC) is common and clinical presentation can vary from minimal to extensive locoregional involvement. Although PTC is generally considered the most benign among all thyroid carcinomas, it may present with local invasion with poor prognosis. Our retrospective study involved 3267 PTC patients undergoing regular follow-up at Chang Gung Medical Center in Linkou, Taiwan. Among them, 269 were PTC cases with ETE, having tumors greater than 1 cm in size and treated with total or complete thyroidectomy with or without lymph node dissection for which the follow-up period was over 10 years. The mean age of 269 cases was 46.8 ± 15.1 (range 11–83 years) years. The number of females was 204 (75.8 %). Patients were categorized into minimal ETE (175 cases) and extensive ETE (94 cases) groups according to surgical findings and pathological reports. Mean follow-up period was 13.3 ± 5.5 (range 0.2–29.3) years, during which 28 (10.4 %) patients died of thyroid cancer; and 63 (23.4 %) of all-cause mortality. Multivariate analysis showed that age, gender, extensive ETE, and lymph node metastasis had a statistically significant effect on thyroid cancer mortality. Survival rates were significantly different between minimal ETE and extensive ETE groups (p < 0.0001). In conclusion, perithyroidal soft tissue involvement by PTC is an important factor that determines patient prognosis and a closer follow-up and more aggressive treatment is necessary for patients who are old, male, extensive ETE, and with lymph node involvement.

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Section: Discussionmentioning

confidence: 99%

Soft tissue invasion of papillary thyroid carcinoma

Lin

Chao

2016

Clin Exp Metastasis

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“…In some cases, recurrence was demonstrated pathologically by surgical resection or biopsy [16]. LFFS was defined as the time interval from the date of primary surgery to the date of local failure, death, or last contact, as appropriate.…”

Section: Methodsmentioning

confidence: 99%

“…LFFS was defined as the time interval from the date of primary surgery to the date of local failure, death, or last contact, as appropriate. Distant metastasis was defined as any recurrence outside of the cervical neck and the upper mediastinum [16]. …”

Section: Methodsmentioning

confidence: 99%

“…Patients were followed up by an endocrinologist, thyroid surgeon, and/or radiation oncologist every 3 months for the first 2 postoperative years, then every 6 months for up to 5 years, and annually thereafter [16]. Follow-up assessment included a physical examination, serum thyroglobulin level, chest X-ray, neck ultrasound and/or CT, 131I whole-body scan, and other radiologic studies, if necessary [3].…”

Section: Methodsmentioning

confidence: 99%

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The role of adjuvant external beam radiation therapy for papillary thyroid carcinoma invading the trachea

et al. 2017

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PurposeTo evaluate the effect of adjuvant external beam radiation therapy (EBRT) on local failure-free survival rate (LFFS) for papillary thyroid cancer (PTC) invading the trachea.Materials and MethodsFifty-six patients with locally advanced PTC invading the trachea were treated with surgical resection. After surgery, 21 patients received adjuvant EBRT and radioactive iodine therapy (EBRT group) and 35 patients were treated with radioactive iodine therapy (control group).ResultsThe age range was 26–87 years (median, 56 years). The median follow-up period was 43 months (range, 4 to 145 months). EBRT doses ranged from 50.4 to 66 Gy (median, 60 Gy). Esophagus invasion and gross residual disease was more frequent in the EBRT group. In the control group, local recurrence developed in 9 (9/35, 26%) and new distant metastasis in 2 (2/35, 6%) patients, occurring 4 to 68 months (median, 37 months) and 53 to 68 months (median, 60 months) after surgery, respectively. Two patients had simultaneous local recurrence and new distant metastasis. There was one local failure in the EBRT group at 18 months after surgery (1/21, 5%). The 5-year LFFS was 95% in the EBRT group and 63% in the control group (p = 0.103). In the EBRT group, one late grade 2 xerostomia was developed.ConclusionAlthough, EBRT group had a higher incidence of esophagus invasion and gross residual disease, EBRT group showed a better 5-year LFFS. Adjuvant EBRT may have contributed to the better LFFS in these patients.

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“…At our center, 10-year recurrence rates of 22.2% in patients with pathologically negative lymph nodes and of 42.1% in those with pathologically positive lymph node metastases have been reported [5]. Although PTC has favorable overall survival outcomes, advanced pT and pN classifications predict higher rates of locoregional recurrence, and several studies have found evidence that the use of adjuvant RT decreased locoregional recurrences [6,7,8,9,10,11,12,13,14]. …”

Section: Introductionmentioning

confidence: 99%

The Role of Adjuvant Radiation Therapy for Locoregionally Advanced Papillary Thyroid Carcinoma

Lee¹,

Kim²,

Baek³

et al. 2016

Oncology

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Objectives: To investigate the role of adjuvant radiation therapy in locoregional control in patients with locoregionally advanced papillary thyroid carcinoma (pT4 or pN1b) based on a comparison of a group that received radiation therapy and a group that did not receive radiation therapy. Methods: A retrospective analysis was performed on 165 patients with locoregionally advanced papillary thyroid carcinoma who underwent treatment between 2002 and 2011. Of these, 32 patients received adjuvant radiation therapy, and 133 patients did not receive radiation therapy. Results: The median follow-up period was 7.2 years (range, 3.4-13.6) for the overall study population. The 10-year locoregional recurrence-free survival rates for patients in the radiation therapy and no radiation therapy groups were 83.9 and 60.8%, respectively (p = 0.037). The overall survival rate and distant recurrence-free survival rate were not different between the two groups (p = 0.076 and p = 0.813, respectively). Multivariate analysis showed that adjuvant radiation therapy was an independent prognostic factor for locoregional recurrence-free survival (p = 0.040). Conclusions: Adjuvant radiation therapy for patients with either pT4 or pN1b disease improved locoregional recurrence-free survival and might be of benefit for patients with these high-risk features by reducing the need for additional salvage treatment after locoregional recurrence.

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Postoperative Simultaneous Integrated Boost-Intensity Modulated Radiation Therapy for Patients with Locoregionally Advanced Papillary Thyroid Carcinoma: Preliminary Results of a Phase II Trial and Propensity Score Analysis

Abstract: Postoperative SIB-IMRT is feasible and effective in improving locoregional control in patients with locally advanced PTC. Large-scale randomized studies are warranted.

Cited by 18 publications

References 34 publications

Soft tissue invasion of papillary thyroid carcinoma

Soft tissue invasion of papillary thyroid carcinoma

The role of adjuvant external beam radiation therapy for papillary thyroid carcinoma invading the trachea

The Role of Adjuvant Radiation Therapy for Locoregionally Advanced Papillary Thyroid Carcinoma

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