Outcome after intensity modulated radiotherapy for anaplastic thyroid carcinoma
Menée sur 13 patients atteints d'un carcinome anaplasique de la thyroïde traités entre 2008 et 2011 (âge : de 43 à 75 ans ; 10 hommes et 3 femmes ; durée médiane de suivi : 9 mois), cette étude chinoise analyse les résultats oncologiques associés à une radiothérapie avec modulation d'intensité en combinaison avec une chimiothérapie et/ou un traitement chirurgical
Background : Anaplastic thyroid carcinoma (ATC) is a malignancy with one of the highest fatality rates. We reviewed our recent clinical experience with intensity modulated radiotherapy (IMRT) combined with surgery and chemotherapy for the management of ATC Methods : 13 patients with ATC who were treated by IMRT in our institution between October 2008 and February 2011, have been analyzed. The target volume for IMRT was planned to include Gross tumor volume (GTV): primary tumor plus any N + disease (66 Gy/33F/6.6 W), with elective irradiation of thyroid bed, bilateral level II through VI and mediastinal lymph nodes to the level of the carina (54-60 Gy). Five patients received surgical intervention and eleven patients had chemotherapy. Results : The median radiotherapy dose to GTV was 60 Gy/30 fractions/6 weeks. The median survival time of the 13 patients was 9 months. The direct causes of death were distant metastases (75%) and progression of the locoregional disease (25%). Ten patients were spared dyspnea and tracheostomy because their primary neck lesion did not progress. Conclusion : The results showed that IMRT combined by surgery and chemotherapy for ATC might be beneficial to improve locoregional control. Further new therapies are needed to control metastases.
BMC Cancer 2014