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External Beam Radiation for Locally Advanced and Metastatic Differentiated Thyroid Cancer

  • James D. BrierleyEmail author
  • Meredith E. Giuliani
  • Richard W. Tsang
Chapter

Abstract

Although the evidence for a role for external beam radiation therapy (EBRT) comes from single-institution retrospective data, there is convincing evidence that it has a defined role in controlling unresectable differentiated thyroid cancer in the neck and in reducing the risk of local regional recurrence, but only in carefully selected high-risk patients. The evidence that supports the role for EBRT is reviewed. The typical radiation doses and techniques used in our institution are discussed. The role of EBRT in the palliation of symptoms from metastatic disease and newer radiation techniques that can be used to treat and potentially ablate oligometastatic disease is reviewed and examples are given.

Keywords

Thyroid cancer Extrathyroid extension External beam radiotherapy Adjuvant therapy Stereotactic radiotherapy 

References

  1. 1.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC staging cancer manual. 7th ed. New York: Springer; 2010.Google Scholar
  2. 2.
    Brierley JD, Tsang RW. External-beam radiation therapy in the treatment of differentiated thyroid cancer. Semin Surg Oncol. 1999;16(1):42–9. Epub 1999/01/16.CrossRefPubMedGoogle Scholar
  3. 3.
    Chow S-M, Law SCK, Mendenhall WM, Au S-K, Chan PTM, Leung T-W, et al. Papillary thyroid carcinoma: prognostic factors and the role of radioiodine and external radiotherapy. Int J Radiat Oncol Biol Phys. 2002;52(3):784–95.CrossRefPubMedGoogle Scholar
  4. 4.
    Robbins RJ, Wan Q, Grewal RK, Reibke R, Gonen M, Strauss HW, et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning. J Clin Endocrinol Metab. 2006;91(2):498–505.CrossRefPubMedGoogle Scholar
  5. 5.
    Sia MA, Tsang RW, Panzarella T, Brierley JD. Differentiated thyroid cancer with extrathyroidal extension: prognosis and the role of external beam radiotherapy. J Thyroid Res. 2010;2010:183461. Epub 2010/11/05.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Azrif M, Slevin NJ, Sykes AJ, Swindell R, Yap BK. Patterns of relapse following radiotherapy for differentiated thyroid cancer: implication for target volume delineation. Radiother Oncol. 2008;89(1):105–13.CrossRefPubMedGoogle Scholar
  7. 7.
    Schwartz DL, Lobo MJ, Ang KK, Morrison WH, Rosenthal DI, Ahamad A, et al. Postoperative external beam radiotherapy for differentiated thyroid cancer: outcomes and morbidity with conformal treatment. Int J Radiat Oncol Biol Phys. 2009;74(4):1083–91. Epub 2008/12/20.CrossRefPubMedGoogle Scholar
  8. 8.
    Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214. Epub 2009/10/29.CrossRefPubMedGoogle Scholar
  9. 9.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133. Epub 2015/10/16.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Perros P, Boelaert K, Colley S, Evans C, Evans RM, Gerrard Ba G, et al. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf). 2014;81 Suppl 1:1–122. Epub 2014/07/06.CrossRefGoogle Scholar
  11. 11.
    Biermann M, Pixberg M, Riemann B, Schuck A, Heinecke A, Schmid KW, et al. Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer - results after 874 patient-years of follow-up in the MSDS-trial. Nuklearmedizin. 2009;48(3):89–98; quiz N15. Epub 2009/03/27.PubMedGoogle Scholar
  12. 12.
    Tubiana M, Haddad E, Schlumberger M, Hill C, Rougier P, Sarrazin D. External radiotherapy in thyroid cancers. Cancer. 1985;55(9 Suppl):2062–71.CrossRefPubMedGoogle Scholar
  13. 13.
    Farahati J, Reiners C, Stuschke M, Muller SP, Stuben G, Sauerwein W, et al. Differentiated thyroid cancer. Impact of adjuvant external radiotherapy in patients with perithyroidal tumor infiltration (stage pT4). Cancer. 1996;77(1):172–80.CrossRefPubMedGoogle Scholar
  14. 14.
    Tsang RW, Brierley JD, Simpson WJ, Panzarella T, Gospodarowicz MK, Sutcliffe SB. The effects of surgery, radioiodine and external radiation therapy on the clinical outcome of patients with differentiated thyroid cancer. Cancer. 1998;82:375–88.CrossRefPubMedGoogle Scholar
  15. 15.
    Chow SM, Yau S, Lee SH, Leung WM, Law SC. Pregnancy outcome after diagnosis of differentiated thyroid carcinoma: no deleterious effect after radioactive iodine treatment. Int J Radiat Oncol Biol Phys. 2004;59(4):992–1000.CrossRefPubMedGoogle Scholar
  16. 16.
    Kim TH, Yang DS, Jung KY, Kim CY, Choi MS. Value of external irradiation for locally advanced papillary thyroid cancer. Int J Radiat Oncol Biol Phys. 2003;55(4):1006–12.CrossRefPubMedGoogle Scholar
  17. 17.
    Phlips P, Hanzen C, Andry G, Van Houtte P, Fruuling J. Postoperative irradiation for thyroid cancer. Eur J Surg Oncol. 1993;19(5):399–404.PubMedGoogle Scholar
  18. 18.
    Brierley J, Tsang R, Panzarella T, Bana N. Prognostic factors and the effect of treatment with radioactive iodine and external beam radiation on patients with differentiated thyroid cancer seen at a single institution over 40 years. Clin Endocrinol (Oxf). 2005;63(4):418–27.CrossRefGoogle Scholar
  19. 19.
    Keum KC, Suh YG, Koom WS, Cho JH, Shim SJ, Lee CG, et al. The role of postoperative external-beam radiotherapy in the management of patients with papillary thyroid cancer invading the trachea. Int J Radiat Oncol Biol Phys. 2006;65(2):474–80.CrossRefPubMedGoogle Scholar
  20. 20.
    Sun XS, Sun SR, Guevara N, Marcy PY, Peyrottes I, Lassalle S, et al. Indications of external beam radiation therapy in non-anaplastic thyroid cancer and impact of innovative radiation techniques. Crit Rev Oncol Hematol. 2013;86(1):52–68. Epub 2012/10/24.CrossRefPubMedGoogle Scholar
  21. 21.
    Padovani RP, Kasamatsu TS, Nakabashi CC, Camacho CP, Andreoni DM, Malouf EZ, et al. One month is sufficient for urinary iodine to return to its baseline value after the use of water-soluble iodinated contrast agents in post-thyroidectomy patients requiring radioiodine therapy. Thyroid. 2012;22(9):926–30. Epub 2012/07/26.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Gal TJ, Streeter M, Burris J, Kudrimoti M, Ain KB, Valentino J. Quality of life impact of external beam radiotherapy for advanced thyroid carcinoma. Thyroid. 2013;23(1):64–9. Epub 2012/09/14.CrossRefPubMedGoogle Scholar
  23. 23.
    Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12(20 Pt 2):6243s–9. Epub 2006/10/26.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • James D. Brierley
    • 1
    Email author
  • Meredith E. Giuliani
    • 1
  • Richard W. Tsang
    • 1
  1. 1.Department of Radiation OncologyUniversity of Toronto, Princess Margaret Cancer CentreTorontoCanada

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