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

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

Research output: Contribution to journalArticle

24 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)375-382
Number of pages8
JournalJournal of Surgical Oncology
Volume110
Issue number4
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Thyroid Neoplasms
Radiotherapy
Disease-Free Survival
Drug Therapy
Hoarseness
Mucositis
Survival
Dermatitis
Deglutition Disorders
Histology
Neoplasm Metastasis
Incidence
Therapeutics

Keywords

  • chemoradiation
  • IMRT
  • radiation therapy
  • thyroid cancer

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer. / Romesser, Paul B.; Sherman, Eric J.; Shaha, Ashok R.; Lian, Ming; Wong, Richard J.; Sabra, Mona; Rao, Shyam; Fagin, James A.; Tuttle, R. Michael; Lee, Nancy Y.

In: Journal of Surgical Oncology, Vol. 110, No. 4, 01.01.2014, p. 375-382.

Research output: Contribution to journalArticle

Romesser, PB, Sherman, EJ, Shaha, AR, Lian, M, Wong, RJ, Sabra, M, Rao, S, Fagin, JA, Tuttle, RM & Lee, NY 2014, 'External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer', Journal of Surgical Oncology, vol. 110, no. 4, pp. 375-382. https://doi.org/10.1002/jso.23656
Romesser, Paul B. ; Sherman, Eric J. ; Shaha, Ashok R. ; Lian, Ming ; Wong, Richard J. ; Sabra, Mona ; Rao, Shyam ; Fagin, James A. ; Tuttle, R. Michael ; Lee, Nancy Y. / External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer. In: Journal of Surgical Oncology. 2014 ; Vol. 110, No. 4. pp. 375-382.
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T1 - External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer

AU - Romesser, Paul B.

AU - Sherman, Eric J.

AU - Shaha, Ashok R.

AU - Lian, Ming

AU - Wong, Richard J.

AU - Sabra, Mona

AU - Rao, Shyam

AU - Fagin, James A.

AU - Tuttle, R. Michael

AU - Lee, Nancy Y.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - 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.

AB - 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.

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