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Current Oncology
Volume 24
Issue 3
10.3747/co.24.3551
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Patterns of Failure in Anaplastic and Differentiated Thyroid Carcinoma Treated with Intensity-Modulated Radiotherapy

by
H. Vulpe
1,
J. Y. Y. Kwan
1,
A. McNiven
1,
J. D. Brierley
1,
R. Tsang
1,
B. Chan
2,
D. P. Goldstein
3,
L. W. Le
4,
A. Hope
1 and
Meredith Giuliani
1,*
1
Princess Margaret Cancer Centre, Department of Radiation Oncology, 610 University Avenue, Toronto, ON M5G 2M9, Canada
2
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
3
Department of Otolaryngology-Head and Neck Surgery, Toronto, ON, Canada
4
Princess Margaret Cancer Centre, Department of Biostatistics, University of Toronto, Toronto, ON M5G 2M9, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2017, 24(3), 226-232; https://doi.org/10.3747/co.24.3551
Submission received: 4 March 2017 / Revised: 5 April 2017 / Accepted: 9 May 2017 / Published: 1 June 2017

Abstract

Background: The radiotherapy (RT) volumes in anaplastic (ATC) and differentiated thyroid carcinoma (DTC) are controversial. Methods: We retrospectively examined the patterns of failure after postoperative intensity-modulated RT for ATC and DTC. Computed tomography images were rigidly registered with the original RT plans. Recurrences were considered in-field if more than 95% of the recurrence volume received 95% of the prescribed dose, out-of-field if less than 20% received 95% of the dose, and marginal otherwise. Results: Of 30 DTC patients, 4 developed regional recurrence: 1 being in-field (level III), and 3 being out-of-field (all level II). Of 5 ATC patients, all 5 recurred at 7 sites: 2 recurrences being local, and 5 being regional [2 marginal (intramuscular to the digastric and sternocleidomastoid), 3 out-of-field (retropharyngeal, soft tissues near the manubrium, and lateral to the sternocleidomastoid)]. Conclusions: In DTC, locoregional recurrence is unusual after RT. Out-of-field DTC recurrences infrequently occurred in level II. Enlarged treatment volumes to level II must be balanced against a potentially greater risk of toxicity.
Keywords: thyroid neoplasms; recurrence; radiotherapy; anaplastic thyroid carcinoma; papillary carcinoma thyroid neoplasms; recurrence; radiotherapy; anaplastic thyroid carcinoma; papillary carcinoma

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MDPI and ACS Style

Vulpe, H.; Kwan, J.Y.Y.; McNiven, A.; Brierley, J.D.; Tsang, R.; Chan, B.; Goldstein, D.P.; Le, L.W.; Hope, A.; Giuliani, M. Patterns of Failure in Anaplastic and Differentiated Thyroid Carcinoma Treated with Intensity-Modulated Radiotherapy. Curr. Oncol. 2017, 24, 226-232. https://doi.org/10.3747/co.24.3551

AMA Style

Vulpe H, Kwan JYY, McNiven A, Brierley JD, Tsang R, Chan B, Goldstein DP, Le LW, Hope A, Giuliani M. Patterns of Failure in Anaplastic and Differentiated Thyroid Carcinoma Treated with Intensity-Modulated Radiotherapy. Current Oncology. 2017; 24(3):226-232. https://doi.org/10.3747/co.24.3551

Chicago/Turabian Style

Vulpe, H., J. Y. Y. Kwan, A. McNiven, J. D. Brierley, R. Tsang, B. Chan, D. P. Goldstein, L. W. Le, A. Hope, and Meredith Giuliani. 2017. "Patterns of Failure in Anaplastic and Differentiated Thyroid Carcinoma Treated with Intensity-Modulated Radiotherapy" Current Oncology 24, no. 3: 226-232. https://doi.org/10.3747/co.24.3551

APA Style

Vulpe, H., Kwan, J. Y. Y., McNiven, A., Brierley, J. D., Tsang, R., Chan, B., Goldstein, D. P., Le, L. W., Hope, A., & Giuliani, M. (2017). Patterns of Failure in Anaplastic and Differentiated Thyroid Carcinoma Treated with Intensity-Modulated Radiotherapy. Current Oncology, 24(3), 226-232. https://doi.org/10.3747/co.24.3551

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