Clinical outcome of anaplastic thyroid carcinoma treated with radiotherapy of once- and twice-daily fractionation regimens

✍ Scribed by Yongjin Wang; Richard Tsang; Sylvia Asa; Brendan Dickson; Tamara Arenovich; James Brierley

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 112 KB
• Volume: 107
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/cncr.22203

✦ Synopsis

Abstract

BACKGROUND

The purpose was to assess local control, survival, and toxicity after radiotherapy in patients with anaplastic thyroid carcinoma, and to compare clinical outcomes between once‐daily and twice‐daily fractionation regimens.

METHODS

A retrospective review of patients with anaplastic thyroid carcinoma (n = 47) who underwent external beam radiotherapy from 1983 to 2004 was conducted. Twenty‐three patients underwent radical radiotherapy with a radiation dose >40 Gy, and 24 patients underwent palliative radiotherapy with a dose ≤40 Gy. Of radical radiotherapy, radiation was given with once‐daily (14 patients) or twice‐daily fractionation (9 patients; 1.5 Gy per fraction) to a total dose of 45–66 Gy. Most patients (37 patients; 78.7%) were followed to death.

RESULTS

The 6‐month local progression‐free rate in patients who underwent radical radiotherapy was 94.1%, significantly higher compared with palliative radiotherapy (64.6%; P = .02). The median actuarial overall survival was greater in patients with radical radiotherapy (11.1 months) compared with palliative radiotherapy (3.2 months; P < .0001). The median overall survival in patients with twice‐daily fractionation (13.6 months) was 3.3 months longer than patients treated with once‐daily fractionation (10.3 months), but the difference was not statistically significant (P = .3). For patients treated with twice‐daily fractionation, 3 patients had Grade 3 acute skin toxicity, and no patient had Grade 3 or higher esophageal toxicity.

CONCLUSIONS

Radiotherapy can result in local control of anaplastic thyroid carcinoma. A twice‐daily fractionation regimen is well tolerated and has a trend to longer survival, which deserves a larger study. Cancer 2006. © 2006 American Cancer Society.