Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Treatment outcomes of radiotherapy for anaplastic thyroid cancer

  • Park, Jong Won (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Choi, Seo Hee (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Yoon, Hong In (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Lee, Jeongshim (Department of Radiation Oncology, Inha University Hospital) ;
  • Kim, Tae Hyung (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Kim, Jun Won (Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Ik Jae (Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Received : 2018.01.24
  • Accepted : 2018.05.29
  • Published : 2018.06.30
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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 ${\geq}40Gy$. 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 ($EQD2_{10}$ 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ${\geq}grade$ 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.

Keywords

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