Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep;110(4):375-82.
doi: 10.1002/jso.23656. Epub 2014 Jun 24.

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

Paul B Romesser  1 , Eric J Sherman, Ashok R Shaha, Ming Lian, Richard J Wong, Mona Sabra, Shyam S Rao, James A Fagin, R Michael Tuttle, Nancy Y Lee
Affiliations

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

Paul B Romesser et al. J Surg Oncol. 2014 Sep.

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.

Keywords: IMRT; chemoradiation; radiation therapy; thyroid cancer.

PubMed Disclaimer

Conflict of interest statement

The authors declared that they have no conflict of interests.

Figures

Fig. 1.
Fig. 1.
Pre-external beam radiation therapy treatment characteristics. RAI, radioiodine.
Fig. 2.
Fig. 2.
A: Locoregional progression-free survival. B:M0 versus M1. C: Well-/moderately differentiated versus poorly differentiated histology. D:External beam radiation therapy (EBRT) versus concurrent chemoradiation therapy (CCRT).
Fig. 3.
Fig. 3.
A: Distant metastasis-free survival. B: Well-/moderately differentiated versus poorly differentiated histology. C: External beam radiation therapy (EBRT) versus concurrent chemoradiation therapy (CCRT).
Fig. 4.
Fig. 4.
A: Overall survival. B: M0 versus M1. C: External beam radiation therapy (EBRT) versus concurrent chemoradiation therapy (CCRT). D: Well-/moderately differentiated versus poorly differentiated histology Presented in part as an oral presentation at the 2nd World Congress on Thyroid Cancer on July 10–14th, 2013 in Toronto, Canada and as a poster at the Multidisciplinary Head and Neck Cancer Symposium on February 20–22, 2014 in Scottsdale, Arizona.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. American Cancer Society. Cancer Facts and Figures 2013. InAtlanta, GA: American Cancer Society.
    1. Hundahl SA, Fleming ID, Fremgen AM, et al.: A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995 [see comments]. Cancer 1998;83:2638–2648. - PubMed
    1. Mazzaferri EL, Kloos RT: Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 2001;86:1447–1463. - PubMed
    1. Biermann M, Pixberg MK, Schuck A, et al.: Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy. Nuklearmedizin 2003;42:244–250. - PubMed
    1. Brierley J, Sherman E: The role of external beam radiation and targeted therapy in thyroid cancer. Semin Radiat Oncol 2012;22:254–262. - PubMed