Meredith Giuliani1, James Brierley. 1. aDepartment of Radiation Oncology, University of Toronto bDepartment of Radiation Oncology, Princess Margaret Cancer Centre, Toronto.
Abstract
PURPOSE OF REVIEW: The role of external beam radiation therapy (EBRT) in the management of thyroid cancer is not clearly defined. In the absence of randomized studies, the review aims to identify any recent literature that helps define the role. RECENT FINDINGS: In differentiated thyroid cancer, single institutional studies report durable locoregional disease control in patients considered to be at high risk of local relapse after EBRT and recent guidelines are consistent in their recommendations. In medullary thyroid cancer, the evidence is more limited but again there is benefit in selected cases. In anaplastic thyroid cancer, multimodality therapy is superior to surgery alone in achieving local control and possibly survival but the benefit must be weighed against the toxicity. Newer radiation techniques may help reduce toxicity. SUMMARY: Although surgery is the main treatment for thyroid carcinoma, EBRT has a role in the adjuvant setting following surgery in high-risk patients and in unresectable cancer. Advances in the delivery of external beam radiotherapy, including intensity-modulated radiotherapy reduces toxicity.
PURPOSE OF REVIEW: The role of external beam radiation therapy (EBRT) in the management of thyroid cancer is not clearly defined. In the absence of randomized studies, the review aims to identify any recent literature that helps define the role. RECENT FINDINGS: In differentiated thyroid cancer, single institutional studies report durable locoregional disease control in patients considered to be at high risk of local relapse after EBRT and recent guidelines are consistent in their recommendations. In medullary thyroid cancer, the evidence is more limited but again there is benefit in selected cases. In anaplastic thyroid cancer, multimodality therapy is superior to surgery alone in achieving local control and possibly survival but the benefit must be weighed against the toxicity. Newer radiation techniques may help reduce toxicity. SUMMARY: Although surgery is the main treatment for thyroid carcinoma, EBRT has a role in the adjuvant setting following surgery in high-risk patients and in unresectable cancer. Advances in the delivery of external beam radiotherapy, including intensity-modulated radiotherapy reduces toxicity.
Authors: Jonathan Khalifa; Laure Vieillevigne; Sabrina Boyrie; Monia Ouali; Thomas Filleron; Michel Rives; Anne Laprie Journal: Radiat Oncol Date: 2014-11-26 Impact factor: 3.481