Abstract
We evaluated treatment outcomes of external beam radiation therapy (EBRT) for unresectable locally advanced thyroid cancer (LATC) with or without metastasis. We enrolled 11 LATC patients who underwent EBRT (median age: 76 (45–83) years; six males and five females). Eastern Cooperative Oncology Group performance statuses of 0 (n = 3), 1 (n = 1), 2 (n = 6), and 3 (n = 1) were observed. Histologic types included papillary carcinoma (n = 5), anaplastic carcinoma (n = 3), and squamous cell carcinoma (n = 3). The organs invaded by the tumor that caused it to be deemed unresectable were common carotid artery (n = 5), trachea (n = 4), aorta (n = 1) and larynx (n = 1). The median follow-up time was 6 months. One, seven, two, and one patient showed complete response (CR), partial response (PR), stable disease, and progressive disease, respectively. The rate of local CR+PR was 73%; moreover, 75% of patients achieved a >30% tumor size reduction within 6 months. The median local progression-free survival of patients with local CR+PR was 11.5 (4–68) months. The median overall survival was 6 (1–68) months. Grade 3 acute complications occurred in five (45%) patients. No patients had Grade 4 or 5 complications. In conclusion, EBRT reduced the tumor volume in 75% of LATC patients without inducing severe toxicity. This therapy should be considered as a treatment option for LATC.
Highlights
Surgical resection with or without radioactive iodine is a standard therapy for operable advanced thyroid cancer [1,2,3]
Only a few studies reported on external beam radiation therapy (EBRT) for unresectable locally advanced thyroid cancer (LATC), and one of them reported that locoregional disease control at 1 year was 33% in patients with gross unresectable thyroid cancer treated using EBRT with a 60–70 Gy dose [10]
Four patients underwent chemotherapy or tyrosine kinase inhibitors (TKIs) (TS-1 (n = 2), nedaplatin/etoposide (n = 1), and sorafenib followed by lenvatinib (n = 1)) after completing EBRT as adjuvant or second-line treatment for progression
Summary
Surgical resection with or without radioactive iodine is a standard therapy for operable advanced thyroid cancer [1,2,3]. Unresectable thyroid cancers can be treated using three tyrosine kinase inhibitors (TKIs), namely lenvatinib, sorafenib, and vandetanib. These TKIs have shown high response rates and survival benefits in phase II/III studies [4,5,6]. The role of external beam radiation therapy (EBRT) for unresectable thyroid cancer remains unclear. Only a few studies reported on EBRT for unresectable LATC, and one of them reported that locoregional disease control at 1 year was 33% in patients with gross unresectable thyroid cancer treated using EBRT with a 60–70 Gy dose [10]. This retrospective study aimed to evaluate the efficacy and tolerability of EBRT for unresectable LATC
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