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Treatment outcomes of radiotherapy for anaplastic thyroid cancer

Authors
 Jong Won Park  ;  Seo Hee Choi  ;  Hong In Yoon  ;  Jeongshim Lee  ;  Tae Hyung Kim  ;  Jun Won Kim  ;  Ik Jae Lee 
Citation
 RADIATION ONCOLOGY JOURNAL, Vol.36(2) : 103-113, 2018 
Journal Title
 RADIATION ONCOLOGY JOURNAL 
ISSN
 2234-1900 
Issue Date
2018
Keywords
Intensity-modulated radiotherapy ; Progression-free survival ; Radiotherapy ; Surgery ; Anaplastic thyroid carcinoma
Abstract
PURPOSE: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). Materials and. METHODS: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ≥40 Gy. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. RESULTS: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT (EQD210 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ≥grade III occurred. CONCLUSION: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.
DOI
10.3857/roj.2018.00045
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163134
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