<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2018-0038_s_006_w2aab3b7b5b1b6b1aab1c18b1Aa"><h3>Background</h3><p>Locoregional recurrence is common in patients with locally advanced differentiated thyroid carcinoma (DTC). Our aim was to find out the rate of locoregional control of the disease after external beam radiotherapy (EBRT) of the neck and mediastinum in patients with DTC and pT4 tumor.</p></sec><sec id="j_raon-2018-0038_s_007_w2aab3b7b5b1b6b1aab1c18b2Aa"><h3>Patients and methods</h3><p>Altogether 91 patients (47 males, 44 females, median age 61 years) with DTC had EBRT of the neck and mediastinum as part of the multimodal treatment of pT4 tumor (63 cases pT4a, 28 cases pT4b) from the year 1973 to 2015. Data on clinical factors, histopathology and recurrence were collected. Disease-free, disease-specific and overall survival was calculated.</p></sec><sec id="j_raon-2018-0038_s_008_w2aab3b7b5b1b6b1aab1c18b3Aa"><h3>Results</h3><p>Median tumor size was 5 cm (range 1–30 cm). Out of 91 patients, 23 had distant and 38 regional metastases. A total or near-total thyroidectomy, lobectomy, subtotal thyroidectomy and lymph node dissection was performed in 70%, 14%, 2% and 30% of cases, respectively. Thirteen percent of patients were not treated with surgery. All patients had EBRT and 39 had chemotherapy. Radioiodine (RAI) ablation of thyroid remnant and RAI therapy was applied in 90% and 40% of cases, respectively. Recurrence was diagnosed in 29/64 patients without a persistent disease: locoregional and distant in 16 and 13 cases, respectively. Five-year and ten-year disease-free survival rate was 64% and 48%, respectively.</p></sec><sec id="j_raon-2018-0038_s_009_w2aab3b7b5b1b6b1aab1c18b4Aa"><h3>Conclusions</h3><p>The majority of patients with DTC and pT4 tumors who were treated with EBRT of the neck and mediastinum region as part of multimodal treatment have long-lasting locoregional control of the disease.</p></sec></abstract>

BackgroundLocoregional recurrence is common in patients with locally advanced differentiated thyroid carcinoma (DTC). Our aim was to find out the rate of locoregional control of the disease after external beam radiotherapy (EBRT) of the neck and mediastinum in patients with DTC and pT4 tumor.Patients and methodsAltogether 91 patients (47 males, 44 females, median age 61 years) with DTC had EBRT of the neck and mediastinum as part of the multimodal treatment of pT4 tumor (63 cases pT4a, 28 cases pT4b) from the year 1973 to 2015. Data on clinical factors, histopathology and recurrence were collected. Disease-free, disease-specific and overall survival was calculated.ResultsMedian tumor size was 5 cm (range 1–30 cm). Out of 91 patients, 23 had distant and 38 regional metastases. A total or near-total thyroidectomy, lobectomy, subtotal thyroidectomy and lymph node dissection was performed in 70%, 14%, 2% and 30% of cases, respectively. Thirteen percent of patients were not treated with surgery. All patients had EBRT and 39 had chemotherapy. Radioiodine (RAI) ablation of thyroid remnant and RAI therapy was applied in 90% and 40% of cases, respectively. Recurrence was diagnosed in 29/64 patients without a persistent disease: locoregional and distant in 16 and 13 cases, respectively. Five-year and ten-year disease-free survival rate was 64% and 48%, respectively.ConclusionsThe majority of patients with DTC and pT4 tumors who were treated with EBRT of the neck and mediastinum region as part of multimodal treatment have long-lasting locoregional control of the disease.

Locoregional disease control after external beam radiotherapy in 91 patients with differentiated thyroid carcinoma and pT4 tumor stage - a single institution experience

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundLocoregional recurrence is common in patients with locally advanced differentiated thyroid carcinoma (DTC). Our aim was to find out the rate of...

Characteristic	Subgroup	Number of Patients
Surgery of the thyroid	Lobectomy or less	15
	Total or near-total thyroidectomy	64
	Without surgery	12
Neck dissection	No	64
Neck dissection	Yes	27
Radioiodine ablation	No	9
Radioiodine ablation	Yes	82
Therapy with radioiodine	No	54
Therapy with radioiodine	Yes	37
Radiotherapy-Neck region	No	0
Radiotherapy-Neck region	Yes	91
Chemotherapy	No	52
Chemotherapy	Yes	39
Tyrosine kinase inhibitors	No	89
Tyrosine kinase inhibitors	Yes	2

Characteristic	Subgroup	Number of patients
Gender	Female	44
Gender	Male	47
Patient’s age	44 or less	15
Patient’s age	45 or more	76
Tumor diameter (cm)	1-9	75
Tumor diameter (cm)	9.1-30	16
T stage	pT4a	63
T stage	pT4b	28
Lymph nodes metastases	No	53
Lymph nodes metastases	Yes	38
Distant metastases	No	68
Distant metastases	Yes	23
Residual tumor after surgery	R0	27
	R1	47
	R2	5
	No surgery	12
Recurrence	No	39
	Yes-distant	13
	Yes-locoregional	16
	Disease present permanently	23
Outcome	Alive	44
	Dead of distant disease	29
	Dead of local disease	1
	Dead of local and distant disease	4
	Dead of other causes	10
	Lost from follow-up	3

Locoregional disease control after external beam radiotherapy in 91 patients with differentiated thyroid carcinoma and pT4 tumor stage - a single institution experience

Article Category: Research Article

Pubblicato online: 22 set 2018

Pagine: 453 - 460

Ricevuto: 04 mag 2018

Accettato: 23 mag 2018

DOI: https://doi.org/10.2478/raon-2018-0038

© 2018 Nikola Besic, Marta Dremelj, Gasper Pilko, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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Treatment of patients

Clinical data and outcome of 91 patients with pT4 tumor stage