ROLE OF EXTERNAL BEAM RADIOTHERAPY IN PATIENTS WITH ADVANCED OR RECURRENT NONANAPLASTIC THYROID CANCER: MEMORIAL SLOAN-KETTERING CANCER CENTER EXPERIENCE
ROLE OF EXTERNAL BEAM RADIOTHERAPY IN PATIENTS WITH ADVANCED OR RECURRENT NONANAPLASTIC THYROID CANCER: MEMORIAL SLOAN-KETTERING CANCER CENTER EXPERIENCE
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DOI：
10.1016/j.ijrobp.2008.05.012
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发表时间：
2009-03-01
影响因子：
7
通讯作者：
Lee, Nancy Y.
中科院分区：
文献类型：
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作者：
Terezakis, Stephanie A.;Lee, Kyungiviouk S.;Lee, Nancy Y.
目的：外照射放射治疗（EBRT）在非未分化甲状腺癌的治疗中起着有争议的作用。我们回顾了我们的机构的结果与EBRT治疗晚期或复发性非间变性甲状腺cancer.Methods和材料：1989年4月至2006年4月，76例非间变性甲状腺癌患者进行了EBRT治疗。存活患者的中位随访时间为35.3个月（范围：4.2 - 178.4）。病变主要为晚期，包括5例（7%）T2期、5例（7%）T3期和64例（84%）T4期患者。60例患者（79%）出现NI期疾病。在27例患者（36%）中确定了EBRT前的远处转移。EBRT的中位总剂量为6，300 cGy。检查的组织学特征包括12例（16%）的髓样和64例（84%）的非髓样。76例患者中，71例（93%）在RT前接受了手术治疗，56例（74%）接受了放射性碘治疗。结果：所有组织学类型的2年和4年总体局部控制率分别为86%和72%，所有患者的2年和4年总生存率分别为74%和55%。完全切除、显微镜下残留病变或大体残留病变患者的局部控制、总生存率或无远处转移生存率无显著差异。3级急性粘膜炎和吞咽困难分别发生在14例（18%）和24例（32%）患者中。晚期不良反应是值得注意的经皮内镜胃造口管使用4例（5%）。结论：我们的研究结果表明，EBRT是有效的局部区域控制选定的局部晚期或复发性非间变性甲状腺恶性肿瘤，可接受的急性毒性。(c)2009 Elsevier Inc.
Purpose: External beam radiotherapy (EBRT) plays a controversial role in the management of nonanaplastic thyroid cancer. We reviewed our institution's outcomes in patients treated with EBRT for advanced or recurrent nonanaplastic thyroid cancer.Methods and Materials: Between April 1989 and April 2006, 76 patients with nonanaplastic thyroid cancer were treated with EBRT. The median follow-up for the surviving patients was 35.3 months (range, 4.2-178.4). The lesions were primarily advanced and included Stage T2 in 5 (7%), T3 in 5 (7%), and T4 in 64 (84%) patients. Stage NI disease was present in 60 patients (79%). Distant metastases before EBRT were identified in 27 patients (36%). The median total EBRT dose delivered was 6,300 cGy. The histologic features examined included medullary in 12 patients (16%) and nonmedullary in 64 (84%). Of the 76 patients, 71 (93%) had undergone surgery before RT, and radioactive iodine treatment was used in 56 patients (74%).Results: The 2- and 4-year overall locoregional control rate for all histologic types was 86% and 72%, respectively, and the 2- and 4-year overall survival rate for all patients was 74% and 55%, respectively. No significant differences were found in locoregional control, overall survival, or distant metastases-free survival for patients with complete resection, microscopic residual disease, or gross residual disease. Grade 3 acute mucositis and dysphagia occurred in 14 (18%) and 24 (32%) patients, respectively. Late adverse toxicity was notable for percutaneous endoscopic gastrostomy tube use in 4 patients (5%).Conclusion: The results of our study have shown that EBRT is effective for locoregional control of selected locally advanced or recurrent nonanaplastic thyroid malignancies, with acceptable acute toxicity. (c) 2009 Elsevier Inc.