Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer
Background: The role of postoperative external beam radiotherapy (EBRT) in patients with residual iodine refractory-differentiated thyroid cancer (IR-DTC) is still inconclusive. The aim of this retrospective study was to evaluate locoregional control (LRC) and overall survival (OS), and potential si...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-01-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/11/1/ETJ-21-0033.xml |
| _version_ | 1797955250376671232 |
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| author | Andries H Groen Deborah van Dijk Wim Sluiter Thera P Links Hendrik P Bijl John T M Plukker |
| author_facet | Andries H Groen Deborah van Dijk Wim Sluiter Thera P Links Hendrik P Bijl John T M Plukker |
| author_sort | Andries H Groen |
| collection | DOAJ |
| description | Background: The role of postoperative external beam radiotherapy (EBRT) in patients with residual iodine refractory-differentiated thyroid cancer (IR-DTC) is still inconclusive. The aim of this retrospective study was to evaluate locoregional control (LRC) and overall survival (OS), and potential side effects after postoperative EB RT for both microscopic and macroscopic non-radically resected, locally advanced IR-DTC.
Methods: Between 1990 and 2016, 49 patients with locally advanced IR-D TC received EBRT for microscopic (R1; n = 28) or macroscopic (R2; n = 21) locoregional residual disease. For more insight into the added effect of EBRT, we perf ormed an intrapatient sub-analysis in 32 patients who had undergone more than 1 surgical intervention, comparing LRC after primary, curative-intended surgery with LRC after repeated surgery plus EBRT. To estimate LRC and OS, we used Kaplan–Meier curves. From 2007 onward, we prospectively recorded toxicity data in our head and neck cancer database (n = 10).
Results: LRC rates 5 years after EBRT were higher for R1 (84.3%) than for R2 (44.9%) residual disease (P = 0.016). The 5-year OS rate after EBRT was 72.1% for R1 and 33. 1% for R2 disease (P = 0.003). In the intrapatient analysis (n = 32), LRC rates were 6.3% 5 years after only initial surgery and 77.9% after repeated sur gery with EBRT (P < 0.001). Acute toxicity was limited to grade I and II xerostomia, mucosi tis, and hoarseness; only one patient developed late grade III dysphagia.
Conclusions: Postoperative EBRT is associated with long-lasting LRC and OS with acceptable toxicity in patients with locally advanced IR-DTC, e specially in microscopic residual disease. |
| first_indexed | 2024-04-10T23:30:12Z |
| format | Article |
| id | doaj.art-faa0d39a9b4046fd88087b5d842a1a9c |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-04-10T23:30:12Z |
| publishDate | 2023-01-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-faa0d39a9b4046fd88087b5d842a1a9c2023-01-12T07:01:05ZengBioscientificaEuropean Thyroid Journal2235-08022023-01-0111119https://doi.org/10.1530/ETJ-21-0033Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancerAndries H Groen0Deborah van Dijk1Wim Sluiter2Thera P Links3Hendrik P Bijl4John T M Plukker5Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsBackground: The role of postoperative external beam radiotherapy (EBRT) in patients with residual iodine refractory-differentiated thyroid cancer (IR-DTC) is still inconclusive. The aim of this retrospective study was to evaluate locoregional control (LRC) and overall survival (OS), and potential side effects after postoperative EB RT for both microscopic and macroscopic non-radically resected, locally advanced IR-DTC. Methods: Between 1990 and 2016, 49 patients with locally advanced IR-D TC received EBRT for microscopic (R1; n = 28) or macroscopic (R2; n = 21) locoregional residual disease. For more insight into the added effect of EBRT, we perf ormed an intrapatient sub-analysis in 32 patients who had undergone more than 1 surgical intervention, comparing LRC after primary, curative-intended surgery with LRC after repeated surgery plus EBRT. To estimate LRC and OS, we used Kaplan–Meier curves. From 2007 onward, we prospectively recorded toxicity data in our head and neck cancer database (n = 10). Results: LRC rates 5 years after EBRT were higher for R1 (84.3%) than for R2 (44.9%) residual disease (P = 0.016). The 5-year OS rate after EBRT was 72.1% for R1 and 33. 1% for R2 disease (P = 0.003). In the intrapatient analysis (n = 32), LRC rates were 6.3% 5 years after only initial surgery and 77.9% after repeated sur gery with EBRT (P < 0.001). Acute toxicity was limited to grade I and II xerostomia, mucosi tis, and hoarseness; only one patient developed late grade III dysphagia. Conclusions: Postoperative EBRT is associated with long-lasting LRC and OS with acceptable toxicity in patients with locally advanced IR-DTC, e specially in microscopic residual disease.https://etj.bioscientifica.com/view/journals/etj/11/1/ETJ-21-0033.xmldifferentiated thyroid cancerradiotherapylocoregional controlside effectssurvival |
| spellingShingle | Andries H Groen Deborah van Dijk Wim Sluiter Thera P Links Hendrik P Bijl John T M Plukker Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer European Thyroid Journal differentiated thyroid cancer radiotherapy locoregional control side effects survival |
| title | Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer |
| title_full | Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer |
| title_fullStr | Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer |
| title_full_unstemmed | Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer |
| title_short | Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer |
| title_sort | postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer |
| topic | differentiated thyroid cancer radiotherapy locoregional control side effects survival |
| url | https://etj.bioscientifica.com/view/journals/etj/11/1/ETJ-21-0033.xml |
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