Radiotherapy in well‐differentiated thyroid cancer: is it underutilized?

So, Kevin; Smith, Robin; Davis, Sally J.

doi:10.1111/ans.13374

Cited by 9 publications

(6 citation statements)

References 27 publications

(66 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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“…Ce taux est supérieur à celui retrouvé dans notre série, mais il s'agit de survies après prise en charge initiale et non après une médiane de deux rechutes comme dans notre cohorte. So et al ont publié une cohorte de 32 patients atteints d'un cancer de la thyroïde ayant reçu de la radiothérapie dont six avaient reçu de la radiothérapie pour une rechute cervicale [18]. Il n'y a pas eu de rechute cervicale chez ces six patients mais le suivi n'était pas précisé et l'effectif faible.…”

Section: Discussionunclassified

Efficacité et tolérance de la radiothérapie externe pour les patients atteints d'une récidive d'un carcinome différencié de la thyroïde

Giraud

Blais

Jouinot

et al. 2022

Cancer/Radiothérapie

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“…A 20% and 50% three-year locoregional control has been obtained in patients treated with palliative or radical radiotherapy, respectively, in unresectable DTC, with no further attempt to perform surgery after EBRT. Frequently, cases in these analyses had undergone incomplete surgical resections (16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Treatment of Unresectable Differentiated Thyroid Carcinoma With Upfront External Radiotherapy and Salvage Surgery: A STROBE-Compliant Retrospective Cohort Study

et al. 2021

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IntroductionIn patients with unresectable Differentiated thyroid cancer (DTC), the use of external beam radiation therapy (EBRT), leads mostly to palliation. Our aim is to define the role of upfront EBRT, followed or not by salvage surgery, on Progression-free survival (PFS) or Overall survival (OS) in patients with DTC.MethodsThis is a cohort study of patients with initially unresectable DTC who received EBRT. Cohort A received EBRT followed by rescue surgery and cohort B, EBRT only. The Kaplan-Meier method and Cox model were employed for survival analysis.ResultsThirty-three patients were included; 69.6% females and 30.3% males. Mean age was 60.6 and mean tumor diameter was 10.4 cm; 17 and 16 patients were included in cohorts A and B, respectively. Belonging to cohort A (Hazard ratio [HR] 0.177, 95% CI 0.05–0.7) and use of intensity modulated radiotherapy (HR 0.177, 95% CI 0.03–1.08) were associated to better PFS, while high-risk histopathology (HR 6.6, 95% CI 0.9–50) and EBRT dose (HR 1.05, 95% CI 1.01–1.08) were independently associated with lower PFS. Patients from cohort A (HR 0.061, 95% CI 0.01–0.3) had improved OS, while high-risk histopathology (HR 5.7, 95% CI 1.1–28.6) and EBRT dose (HR 1.05, 95% CI 1.01–1.09) were independently associated to worse OS.ConclusionEBRT, and when feasible, salvage surgery, should be an integral part of the therapeutic strategy in initially unresectable DTC.

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Radiotherapy in well‐differentiated thyroid cancer: is it underutilized?

Abstract: Our study suggests that in a select group of patients with well-differentiated thyroid carcinoma, EBRT treatment appears to provide durable tumour and symptom control.

Cited by 9 publications

References 27 publications

Radioiodine Refractory Follicular Thyroid Cancer and Surgery for Cervical Relapse

Radioiodine Refractory Follicular Thyroid Cancer and Surgery for Cervical Relapse

Efficacité et tolérance de la radiothérapie externe pour les patients atteints d'une récidive d'un carcinome différencié de la thyroïde

Treatment of Unresectable Differentiated Thyroid Carcinoma With Upfront External Radiotherapy and Salvage Surgery: A STROBE-Compliant Retrospective Cohort Study

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