The role of postoperative external-beam radiotherapy in the management of patients with papillary thyroid cancer invading the trachea.

Abstract

PURPOSE:

To determine the role of adjuvant external-beam radiotherapy (EBRT) in the management of patients with well-differentiated thyroid cancer invading the trachea.

METHODS AND MATERIALS:

Of 1,098 thyroid cancer patients, 68 (6%) were found to have tracheal invasion, and they all received "shave" excision of the tracheal cartilage. Among them, 12 patients had no postoperative residuum, 43 patients had microscopic residuum, and 13 patients had macroscopic residuum. All patients were divided into two groups according to treatment modality with or without EBRT; (1) the control group (n = 43) and (2) the EBRT group (n = 25).

RESULTS:

The locoregional recurrence rate for EBRT patients was much lower than that of control patients (51% for the control group vs. 8% for the EBRT group) (p < 0.01). The 10-year local progression-free survival rate for the EBRT group was significantly better than that of the control group (89% in the EBRT group vs. 38% in the control group) (log-rank, p < 0.01). The use of adjuvant EBRT after conservative surgery was an independent prognostic factor in univariate and multivariate analyses.

CONCLUSIONS:

External-beam radiotherapy was found to be effective, particularly in patients with thyroid cancer invading the trachea with microscopic or gross residuum after conservative surgery.

• Authors: Ki Chang Keum, Yang Gun Suh, Woong Sub Koom, Jae Ho Cho, Su Jung Shim, Chang Geol Lee, Chung Soo Park, Woong Youn Chung, Gwi Eon Kim
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 65 Issue 2 Pg. 474-80 (Jun 01 2006) ISSN: 0360-3016 [Print] United States
• PMID: 16542796 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Iodine Radioisotopes

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Papillary (mortality, pathology, radiotherapy, surgery)
• Case-Control Studies
• Chi-Square Distribution
• Female
• Humans
• Iodine Radioisotopes (therapeutic use)
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Invasiveness
• Proportional Hazards Models
• Retrospective Studies
• Survival Rate
• Thyroid Neoplasms (mortality, pathology, radiotherapy, surgery)
• Thyroidectomy (methods)
• Tracheal Neoplasms (mortality, pathology, radiotherapy)