Role of adjuvant postoperative external beam radiotherapy for well differentiated thyroid cancer.
10.3857/roj.2013.31.3.162
- Author:
Jeanny KWON
1
;
Hong Gyun WU
;
Yeo Kyu YOUN
;
Kyu Eun LEE
;
Kwang Hyun KIM
;
Do Joon PARK
Author Information
1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. wuhg@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Papillary thyroid cancer;
Follicular thyroid cancer;
Radiotherapy;
Adjuvant
- MeSH:
Adenocarcinoma, Follicular;
Esophagus;
Female;
Follow-Up Studies;
Humans;
Male;
Multivariate Analysis;
Neck;
Neoplasm, Residual;
Recurrence;
Thyroid Gland;
Thyroid Neoplasms;
Trachea
- From:Radiation Oncology Journal
2013;31(3):162-170
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To analyze the outcome of adjuvant postoperative external beam radiotherapy (EBRT) in well-differentiated thyroid cancer (WDTC). MATERIALS AND METHODS: We identified 84 patients treated with EBRT for WDTC from February 1981 to December 2010. Among them, we analyzed 39 patients who received EBRT after initial radical surgery. Twenty-four females and 15 males were included. The median age was 49 years (range, 16 to 72 years). There were 34 papillary thyroid carcinomas and 5 follicular thyroid carcinomas. Most patients showed pathologic T3/T4 stage (54%/26%). Ten patients (25.6%) had gross residual tumors. Five patients (12.8%) had tumor cells at the margin. The median EBRT dose and fraction size were 62.6 Gy and 1.8 to 2.0 Gy, respectively. RESULTS: The median follow-up was 73 months (range, 21 to 372 months). The five-year overall survival (OS) and locoregional recurrence free survival (LRFS) were 97.4% and 86.9%, respectively. Locoregional failures occurred in 5 and all failure sites were the neck node area. In univariate analysis, OS was significantly influenced by invasion of the trachea (p = 0.016) or esophagus (p = 0.006). LRFS was significantly decreased by male (p = 0.020), gross residuum after resection (p = 0.002), close or positive tumor at surgical margin involvement (p = 0.044), and tracheal invasion (p = 0.040). No significant prognostic factor was identified in the multivariate analysis. No patient experienced the Radiation Therapy Oncology Group grade 3 or more toxicity. CONCLUSION: Our locoregional control rate of 87.2% is comparable to historical controls with surgery alone, even though our study had a large proportion of advanced stage. Adjuvant EBRT may an effective and safe treatment option in patients with WDTC.
