External radiotherapy in thyroid cancers
Surgery is the most effective treatment for thyroid cancer; however, in some subsets of patients, the role of radiotherapy (RT) is important. The main indication for external-beam RT is incomplete surgery. When neoplastic tissue is left behind at surgery, RT must be considered, but only if an experienced surgeon feels that everything that can be done has been done. Generally, in those patients, the neoplastic tissue involves the larynx, trachea, esophagus, blood vessels or mediastinum. Of 539 patients with differentiated thyroid cancer treated at Villejuif, France, until 1976, 97 were treated by external radiotherapy after an incomplete surgical excision. Fifteen years after irradiation, the survival rate is 57% and is approximately 40% at 25 years. The relapse-free survival is lower (39% at 15 years). In patients irradiated with an adequate dose (greater than or equal to 50 Gy) to residual neoplastic tissue after incomplete surgery, the incidence of local recurrence is low (actuarial probability of local recurrence 11% at 15 years versus 23% for patients treated by surgery alone, although the irradiated patients had larger and more extensive tumors). This demonstrates the efficacy of external-beam radiotherapy. The effects of radiotherapy on a residual tumor can be monitored by a serum thyroglobulin assay. With regard to local control of tumors, the effectiveness of radioiodine administration is clearly lower. However, since radioiodine facilitates early detection of distant metastases, a combination of external RT and radioiodine is indicated and is well-tolerated.
- Research Organization:
- Institut Gustave- Roussy, Villejuif, France
- OSTI ID:
- 5518649
- Journal Information:
- Cancer (Philadelphia); (United States), Journal Name: Cancer (Philadelphia); (United States) Vol. 55:Suppl. 9; ISSN CANCA
- Country of Publication:
- United States
- Language:
- English
Similar Records
Contralateral breast cancer and other second malignancies in patients treated by breast-conserving therapy with radiation
Medullary thyroid carcinoma: prognostic factors and treatment
Related Subjects
62 RADIOLOGY AND NUCLEAR MEDICINE
BLOOD VESSELS
BODY
BODY AREAS
CARDIOVASCULAR SYSTEM
CHEST
DIGESTIVE SYSTEM
DISEASES
DOSES
ENDOCRINE GLANDS
ESOPHAGUS
GLANDS
GLOBULINS
IODINE ISOTOPES
ISOTOPES
LARYNX
MEDIASTINUM
MEDICINE
METASTASES
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PATIENTS
PROTEINS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SURGERY
SURVIVAL TIME
SYNERGISM
THERAPY
THYROGLOBULIN
THYROID
TRACHEA