Patterns of failure in anaplastic and differentiated thyroid carcinoma treated with intensity-modulated radiotherapy

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Vulpe, H
Kwan, JYY
McNiven, A
Brierley, JD
Tsang, R
Chan, B
Goldstein, DP
Le, LW
Hope, A
Giuliani, M
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2017
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Abstract

Background The radiotherapy (rt) volumes in anaplastic (atc) and differentiated thyroid carcinoma (dtc) are controversial. Methods We retrospectively examined the patterns of failure after postoperative intensity-modulated rt for atc and dtc. Computed tomography images were rigidly registered with the original rt plans. Recurrences were considered in-field if more than 95% of the recurrence volume received 95% of the prescribed dose, out-of-field if less than 20% received 95% of the dose, and marginal otherwise. Results Of 30 dtc patients, 4 developed regional recurrence: 1 being in-field (level iii), and 3 being out-of-field (all level ii). Of 5 atc patients, all 5 recurred at 7 sites: 2 recurrences being local, and 5 being regional [2 marginal (intramuscular to the digastric and sternocleidomastoid), 3 out-of-field (retropharyngeal, soft tissues near the manubrium, and lateral to the sternocleidomastoid)]. Conclusions In dtc, locoregional recurrence is unusual after rt. Out-of-field dtc recurrences infrequently occurred in level ii. Enlarged treatment volumes to level ii must be balanced against a potentially greater risk of toxicity.

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Current Oncology

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24

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3

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© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Oncology and carcinogenesis

Thyroid neoplasms

anaplastic thyroid carcinoma

papillary carcinoma

radiotherapy

recurrence

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Vulpe, H; Kwan, JYY; McNiven, A; Brierley, JD; Tsang, R; Chan, B; Goldstein, DP; Le, LW; Hope, A; Giuliani, M, Patterns of failure in anaplastic and differentiated thyroid carcinoma treated with intensity-modulated radiotherapy, Current Oncology, 2017, 24 (3), pp. e226-e232

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