Postoperative radiotherapy for advanced medullary thyroid cancer--local disease control in the modern era. Head Neck 2008 Jul;30(7):883-8
Date
01/24/2008Pubmed ID
18213725DOI
10.1002/hed.20791Scopus ID
2-s2.0-47549104319 (requires institutional sign-in at Scopus site) 74 CitationsAbstract
BACKGROUND: The purpose of this study is to catalog modern-era postoperative radiotherapy (external beam radiotherapy [EBRT]) outcomes for advanced medullary thyroid cancer.
METHODS: Thirty-four consecutive patients with stage IVa-c disease were evaluated. Ten patients had recurrent disease, 16 had mediastinal involvement, and 10 had distant metastasis. Positive surgical margins were present in 12 cases. Median pre-EBRT serum calcitonin was 556. All patients received conformal EBRT or intensity-modulated radiotherapy. Median EBRT dose was 60 Gy and median follow-up was 46.5 months.
RESULTS: Kaplan-Meier estimates of locoregional relapse-free survival, disease-specific survival, and overall survival at 5 years were 87%, 62%, and 56%, respectively. Disease in 3 patients with gross residual disease was controlled locoregionally. Distant disease at the time of EBRT did not predict survival. Two (9%) patients reported symptomatic chronic morbidity.
CONCLUSION: Surgery followed by EBRT provided durable locoregional disease control with limited morbidity. Postoperative EBRT merits consideration in cases of advanced disease at high risk for locoregional recurrence.
Author List
Schwartz DL, Rana V, Shaw S, Yazbeck C, Ang KK, Morrison WH, Rosenthal DI, Hoff A, Evans DB, Clayman GL, Garden AS, Sherman SIAuthor
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Brachytherapy
Carcinoma, Medullary
Cohort Studies
Disease-Free Survival
Female
Humans
Male
Middle Aged
Neoplasm Staging
Phantoms, Imaging
Postoperative Care
Prognosis
Radiotherapy Dosage
Radiotherapy, Adjuvant
Radiotherapy, Computer-Assisted
Retrospective Studies
Risk Assessment
Survival Analysis
Thyroid Neoplasms
Thyroidectomy
Treatment Outcome
