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External Beam Radiation Therapy in the Treatment of Differentiated Thyroid Cancers

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Thyroid Cancer

Part of the book series: Endocrine Updates ((ENDO,volume 32))

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Abstract

Thyroid cancers include a diffuse group of histologies having intrinsically different biological behaviors and natural histories. Given the location of the thyroid gland in close proximity to major organs, such as the larynx, recurrent laryngeal nerve, trachea, carotid artery, and esophagus, it is well recognized that local control remains itself an important endpoint in the treatment of all these malignancies. With the exception of lymphomas, surgery remains the primary treatment modality. In general, external beam radiation therapy (EBRT), as a locoregional treatment, is indicated in situations where surgery or other alternative relatively less toxic therapies, such as 131I or potentially more specifically targeted systemic therapies, are deemed inappropriate or unsuccessful.

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References

  1. Cooper D, Doherty G, Haugen B, et al. Revised American Thyroid Association Management Guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.

    Article  PubMed  Google Scholar 

  2. Powell C, Newbold K, Harrington K, Bhide S, Nutting C. External beam radiotherapy for differentiated ­thyroid cancer. ClinOncol (R CollRadiol). 2010;22(6):456–63. Epub 2010 Apr 27.

    CAS  Google Scholar 

  3. Simpson W, Panzarella T, Carruthers J, Gospodarowicz M, Sutcliffe S. Papillary and follicular thyroid cancer: impact of treatment in 1578 patients. Int J Radiat Oncol Biol Phys. 1988;14(6):1063–75.

    Article  CAS  PubMed  Google Scholar 

  4. Tubiana M, Haddad E, Schlumberger M, Hill C, Rougier P, Sarrazin D. External radiotherapy in thyroid cancers. Cancer. 1985;55(9 Suppl):2062–71.

    Article  CAS  PubMed  Google Scholar 

  5. Schwartz D, Lobo M, Ang K, 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.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Tsang R, Brierley J, Simpson W, Panzarella T, Gospodarowicz M, Sutcliffe S. The effects of surgery, radioiodine, and external radiation therapy on the clinical outcome of patients with differentiated thyroid carcinoma. Cancer. 1998;82(2):375–88.

    Article  CAS  PubMed  Google Scholar 

  7. Kim J, Leeper R. Treatment of anaplastic giant and spindle cell carcinoma of the thyroid gland with combination Adriamycin and radiation therapy. A new approach. Cancer. 1983;52(6):954–7.

    Article  CAS  PubMed  Google Scholar 

  8. Tallroth E, Wallin G, Lundell G, Löwhagen T, Einhorn J. Multimodality treatment in anaplastic giant cell thyroid carcinoma. Cancer. 1987;60(7):1428–31.

    Article  CAS  PubMed  Google Scholar 

  9. Thames HD, Peters LJ, Withers HR, Fletcher GH. Accelerated fractionation vs hyperfractionation: rationales for several treatments per day. Int J Radiat Oncol Biol Phys. 1983;9(2):127–38.

    Article  PubMed  Google Scholar 

  10. Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol. 2010;11(1):21–8.

    Article  CAS  PubMed  Google Scholar 

  11. Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med. 2006;354(6):567–78.

    Article  CAS  PubMed  Google Scholar 

  12. Kim S, Prichard C, Younes M, et al. Cetuximab and irinotecan interact synergistically to inhibit the growth of orthotopic anaplastic thyroid carcinoma xenografts in nude mice. Clin Cancer Res. 2006;12(2):600–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Shukovsky L, Fletcher G. Time-dose and tumor volume relationships in the irradiation of squamous cell carcinoma of the tonsillar fossa. Radiology. 1973;107(3):621–6.

    CAS  PubMed  Google Scholar 

  14. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21(1):109–22.

    Article  CAS  PubMed  Google Scholar 

  15. Harmer C, Bidmead M, Shepherd S, Sharpe A, Vini L. Radiotherapy planning techniques for thyroid cancer. Br J Radiol. 1998;71(850):1069–75.

    CAS  PubMed  Google Scholar 

  16. Nutting C, Convery D, Cosgrove V, et al. Improvements in target coverage and reduced spinal cord irradiation using intensity-modulated radiotherapy (IMRT) in patients with carcinoma of the thyroid gland. Radiother Oncol. 2001;60(2):173–80.

    Article  CAS  PubMed  Google Scholar 

  17. Urbano T, Clark C, Hansen V, et al. Intensity Modulated Radiotherapy (IMRT) in locally advanced thyroid cancer: acute toxicity results of a phase I study. Radiother Oncol. 2007;85(1):58–63.

    Article  PubMed  Google Scholar 

  18. Meadows K, Amdur R, Morris C, Villaret D, Mazzaferri E, Mendenhall W. External beam radiotherapy for differentiated thyroid cancer. Am J Otolaryngol. 2006;27(1):24–8.

    Article  PubMed  Google Scholar 

  19. Terezakis S, Lee K, Ghossein R, et al. Role of external beam radiotherapy in patients with advanced or recurrent nonanaplastic thyroid cancer: Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys. 2009;73(3):795–801.

    Article  PubMed  Google Scholar 

  20. Bhatia A, Rao A, Ang K, et al. Anaplastic thyroid cancer: clinical outcomes with conformal radiotherapy. Head Neck. 2010;32(7):829–36.

    PubMed  Google Scholar 

  21. Mazzaferri E, Young R. Papillary thyroid carcinoma: a 10 year follow-up report of the impact of therapy in 576 patients. Am J Med. 1981;97:418–28.

    Article  Google Scholar 

  22. Mazzaferri E. Thyroid remnant 131I ablation for papillary and follicular thyroid carcinoma. Thyroid. 1997;7(2):265–71.

    Article  CAS  PubMed  Google Scholar 

  23. McGriff N, Csako G, Gourgiotis L, Lori CG, Pucino F, Sarlis N. Effects of thyroid hormone suppression therapy on adverse clinical outcomes in thyroid cancer. Ann Med. 2002;34(7–8):554–64.

    Article  CAS  PubMed  Google Scholar 

  24. Andersen P, Kinsella J, Loree T, Shaha A, Shah J. Differentiated carcinoma of the thyroid with extrathyroidal extension. Am J Surg. 1995;170(5):467–70.

    Article  CAS  PubMed  Google Scholar 

  25. Patel K, Shaha A. Locally advanced thyroid cancer. Curr Opin Otolaryngol Head Neck Surg. 2005;13(2):112–6.

    Article  PubMed  Google Scholar 

  26. Carcangiu M, Zampi G, Pupi A, Castagnoli A, Rosai J. Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of Florence, Italy. Cancer. 1985;55(4):805–28.

    Article  CAS  PubMed  Google Scholar 

  27. Chow S, Law S, Mendenhall 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.

    Article  PubMed  Google Scholar 

  28. Benbassat C, Mechlis-Frish S, Hirsch D. Clinicopathological characteristics and long-term outcome in patients with distant metastases from differentiated thyroid cancer. World J Surg. 2006;30(6):1088–95.

    Article  PubMed  Google Scholar 

  29. Phlips P, Hanzen C, Andry G, Van Houtte P, Früuling J. Postoperative irradiation for thyroid cancer. Eur J Surg Oncol. 1993;19(5):399–404.

    CAS  PubMed  Google Scholar 

  30. Mazzaferri E, Jhiang S. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994;97(5):418–28.

    Article  CAS  PubMed  Google Scholar 

  31. Samaan N, Schultz P, Hickey R, et al. The results of various modalities of treatment of well differentiated thyroid carcinomas: a retrospective review of 1599 patients. J Clin Endocrinol Metab. 1992;75(3):714–20.

    CAS  PubMed  Google Scholar 

  32. Palme C, Waseem Z, Raza S, Eski S, Walfish P, Freeman J. Management and outcome of recurrent well-differentiated thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2004;130(7):819–24.

    Article  PubMed  Google Scholar 

  33. Stojadinovic A, Shoup M, Ghossein R, et al. The role of operations for distantly metastatic well-differentiated thyroid carcinoma. Surgery. 2002;131(6):636–43.

    Article  PubMed  Google Scholar 

  34. Vassilopoulou-Sellin R, Schultz P, Haynie T. Clinical outcome of patients with papillary thyroid carcinoma who have recurrence after initial radioactive iodine therapy. Cancer. 1996;78(3):493–501.

    Article  CAS  PubMed  Google Scholar 

  35. Hay ID. Papillary thyroid carcinoma. Endocrinol Metab Clin N Amer. 1990;19:545–76.

    CAS  Google Scholar 

  36. Chow S, Yau S, Kwan C, Poon P, Law S. Local and regional control in patients with papillary thyroid ­carcinoma: specific indications of external radiotherapy and radioactive iodine according to T and N categories in AJCC 6th edition. Endocr Relat Cancer. 2006;13(4):1159–72.

    Article  PubMed  Google Scholar 

  37. Noguchi S, Noguchi A, Murakami N, et al. Papillary carcinoma of the thyroid I. Developing pattern of metastasis cancer. 1970;26:1053–60.

    Article  PubMed  Google Scholar 

  38. Sanders EJ, LiVolsi V, Brierley J, Shin J, Randolph G. An evidence-based review of poorly differentiated thyroid cancer. World J Surg. 2007;31(5):934–45.

    Article  PubMed  Google Scholar 

  39. Farahati J, Reiners C, Stuschke M, et al. Differentiated thyroid cancer. Impact of adjuvant external radiotherapy in patients with perithyroidal tumor infiltration (stage pT4). Cancer. 1996;77(1):172–80.

    Article  CAS  PubMed  Google Scholar 

  40. Stojadinovic A, Shoup M, Nissan A, et al. Recurrent differentiated thyroid carcinoma: biological implications of age, method of detection, and site and extent of recurrence. Ann Surg Oncol. 2002;9(8):789–98.

    Article  PubMed  Google Scholar 

  41. Wilson P, Millar B, Brierley J. The management of advanced thyroid cancer. Clin Oncol (R Coll Radiol). 2004;16(8):561–8.

    Article  CAS  Google Scholar 

  42. O’Connell M, A’Hern R, Harmer C. Results of external beam radiotherapy in differentiated thyroid carcinoma: a retrospective study from the Royal Marsden Hospital. Eur J Cancer. 1994;30A(6):733–9.

    Article  PubMed  Google Scholar 

  43. Grant C, Hay I, Gough I, Bergstralh E, Goellner J, McConahey W. Local recurrence in papillary thyroid carcinoma: is extent of surgical resection important? Surgery. 1988;104(6):954–62.

    CAS  PubMed  Google Scholar 

  44. Azrif M, Slevin N, Sykes A, Swindell R, Yap B. Patterns of relapse following radiotherapy for differentiated thyroid cancer: implication for target volume delineation. Radiother Oncol. 2008;89(1):105–13.

    Article  PubMed  Google Scholar 

  45. 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.

    Article  CAS  Google Scholar 

  46. Kim T, Yang D, Jung K, Kim C, Choi M. Value of external irradiation for locally advanced papillary thyroid cancer. Int J Radiat Oncol Biol Phys. 2003;55(4):1006–12.

    Article  PubMed  Google Scholar 

  47. Keum K, Suh Y, Koom W, 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.

    Article  PubMed  Google Scholar 

  48. Foote R, Brown P, Garces Y, McIver B, Kasperbauer J. Is there a role for radiation therapy in the management of Hürthle cell carcinoma? Int J Radiat Oncol Biol Phys. 2003;56(4):1067–72.

    Article  PubMed  Google Scholar 

  49. Ford D, Giridharan S, McConkey C, et al. External beam radiotherapy in the management of differentiated thyroid cancer. Clin Oncol (R Coll Radiol). 2003;15(6):337–41.

    Article  CAS  Google Scholar 

  50. Tuttle R, Leboeuf R, Martorella A. Papillary thyroid cancer: monitoring and therapy. Endocrinol Metab Clin North Am. 2007;36(3):753–78. vii.

    Article  CAS  PubMed  Google Scholar 

  51. Shah J. Exploiting biology in selecting treatment for differentiated cancer of the thyroid gland. Eur Arch Otorhinolaryngol. 2008;265(10):1155–60.

    Article  PubMed  Google Scholar 

  52. Shaha A. Treatment of thyroid cancer based on risk groups. J Surg Oncol. 2006;94(8):683–91.

    Article  PubMed  Google Scholar 

  53. Nishida T, Nakaok A, Hashimoto T. Local control in differentiated thyroid carcinoma with extrathyroidal extension. Am J Surg. 2000;179(2):86–91.

    Article  CAS  PubMed  Google Scholar 

  54. Palme C, Freeman J. Surgical strategy for thyroid bed recurrence in patients with well-differentiated thyroid carcinoma. J Otolaryngol. 2005;34(1):7–12.

    Article  PubMed  Google Scholar 

  55. Hu A, Clark J, Payne R, Eski S, Walfish P, Freeman J. Extrathyroidal extension in well-differentiated thyroid cancer: macroscopic vs microscopic as a predictor of outcome. Arch Otolaryngol Head Neck Surg. 2007;133(7):644–9.

    Article  PubMed  Google Scholar 

  56. Cady B. Seminars in surgical oncology on thyroid cancer. J Surg Oncol. 2006;94(8):646–8.

    Article  PubMed  Google Scholar 

  57. Shaha A. Thyroid carcinoma: implications of prognostic factors. Cancer. 1998;83(3):401–2. discussion 403–404.

    Article  CAS  PubMed  Google Scholar 

  58. Shah J, Loree T, Dharker D, Strong E, Begg C, Vlamis V. Prognostic factors in differentiated carcinoma of the thyroid gland. Am J Surg. 1992;164(6):658–61.

    Article  CAS  PubMed  Google Scholar 

  59. Mills S, Haq M, Smellie W, Harmer C. Hürthle cell carcinoma of the thyroid: Retrospective review of 62 patients treated at the Royal Marsden Hospital between 1946 and 2003. Eur J Surg Oncol. 2009;35(3):230–4.

    Article  CAS  PubMed  Google Scholar 

  60. Carling T, Ocal I, Udelsman R. Special variants of differentiated thyroid cancer: does it alter the extent of surgery versus well-differentiated thyroid cancer? World J Surg. 2007;31(5):916–23.

    Article  PubMed  Google Scholar 

  61. Falvo L, Catania A, Grilli P, Di Matteo F, De Antoni E. Treatment of “locally advanced” well-differentiated thyroid carcinomas. Ann Ital Chir. 2004;75(1):17–21.

    CAS  PubMed  Google Scholar 

  62. Falvo L, Catania A, D’Andrea V, Grilli P, D’Ercole C, De Antoni E. Prognostic factors of insular versus ­papillary/follicular thyroid carcinoma. Am Surg. 2004;70(5):461–6.

    PubMed  Google Scholar 

  63. Biermann M, Pixberg M, Schuck A, et al. Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy. Nuklearmedizin. 2003;42(6):244–50.

    CAS  PubMed  Google Scholar 

  64. Biermann M, Pixberg M, Riemann B, 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.

    PubMed  Google Scholar 

  65. Chow S, Law S, Au S, et al. Changes in clinical presentation, management and outcome in 1348 patients with differentiated thyroid carcinoma: experience in a single institute in Hong Kong, 1960–2000. Clin Oncol (R Coll Radiol). 2003;15(6):329–36.

    Article  CAS  Google Scholar 

  66. Mazzaferri E, Kloos R. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001;86(4):1447–63.

    Article  CAS  PubMed  Google Scholar 

  67. Haq M, Harmer C. Differentiated thyroid carcinoma with distant metastases at presentation: prognostic factors and outcome. Clin Endocrinol (Oxf). 2005;63(1):87–93.

    Article  CAS  Google Scholar 

  68. Kebebew E, Clark O. Differentiated thyroid cancer: “complete” rational approach. World J Surg. 2000;24(8):942–51.

    Article  CAS  PubMed  Google Scholar 

  69. Sheline G, Galante M, Lindsay S. Radiation therapy in the control of persistent thyroid cancer. Am J Roentgenol Radium Ther Nucl Med. 1966;97(4):923–30.

    Article  CAS  PubMed  Google Scholar 

  70. Glanzmann C, Lütolf U. Papillary and follicular thyroid carcinoma: long-term course in 339 patients of the Zurich University Hospital 1960 to 1988 and review. Schweiz Rundsch Med Prax. 1992;81(15):457–67.

    CAS  PubMed  Google Scholar 

  71. Tuttle M, Robbins R, Larson S, Strauss H. Challenging cases in thyroid cancer: a multidisciplinary approach. Eur J Nucl Med Mol Imaging. 2004;31(4):605–12.

    Article  PubMed  Google Scholar 

  72. Rosenbluth B, Serrano V, Happersett L, Shaha A, Tuttle M, et al. Intensity-modulated radiation therapy for the treatment of nonanaplastic thyroid cancer. Int J Radiat Oncol Biol Phys. 2005;63(5):1419–26.

    Article  PubMed  Google Scholar 

  73. Posner M, Quivey J, Akazawa P, et al. Dose optimization for the treatment of anaplastic thyroid carcinoma: a comparison of treatment planning techniques. Int J Radiat Oncol Biol Phys. 2000;48(2):475–83.

    Article  CAS  PubMed  Google Scholar 

  74. Robbins R, Wan Q, Grewal R, et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18 F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning. J Clin Endocrinol Metab. 2006;91(2):498–505.

    Article  CAS  PubMed  Google Scholar 

  75. Wang W, Larson S, Tuttle R, et al. Resistance of [18 F]-fluorodeoxyglucose-avid metastatic thyroid cancer lesions to treatment with high-dose radioactive iodine. Thyroid. 2001;11(12):1169–75.

    Article  CAS  PubMed  Google Scholar 

  76. Kim T, Chung K, Lee Y, et al. The effect of external beam radiotherapy volume on locoregional control in patients with locoregionally advanced or recurrent nonanaplastic thyroid cancer. Radiat Oncol. 2010;5:69.

    Article  PubMed Central  PubMed  Google Scholar 

  77. Falkmer U, Järhult J, Wersäll P, Cavallin-Ståhl E. A systematic overview of radiation therapy effects in skeletal metastases. Acta Oncol. 2003;42(5–6):620–33.

    Article  PubMed  Google Scholar 

  78. Schlumberger M, Challeton C, De Vathaire F, et al. Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J Nucl Med. 1996;37(4):598–605.

    CAS  PubMed  Google Scholar 

  79. Greenblatt D, Chen H. Palliation of advanced thyroid malignancies. Surg Oncol. 2007;16(4):237–47.

    Article  PubMed  Google Scholar 

  80. Datz F. Cerebral edema following iodine-131 therapy for thyroid carcinoma metastatic to the brain. J Nucl Med. 1986;27(5):637–40.

    CAS  PubMed  Google Scholar 

  81. Holmquest D, Lake P. Sudden hemorrhage in metastatic thyroid carcinoma of the brain during treatment with iodine-131. J Nucl Med. 1976;17(4):307–9.

    CAS  PubMed  Google Scholar 

  82. Kim I, Kondziolka D, Niranjan A, Flickinger J, Lunsford L. Gamma knife radiosurgery for metastatic brain tumors from thyroid cancer. J Neurooncol. 2009;93(3):355–9.

    Article  PubMed  Google Scholar 

  83. McWilliams R, Giannini C, Hay I, Atkinson J, Stafford S, Buckner J. Management of brain metastases from thyroid carcinoma: a study of 16 pathologically confirmed cases over 25 years. Cancer. 2003;98(2):356–62.

    Article  PubMed  Google Scholar 

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  1. Department of Radiation Oncology, Cedars-Sinai Medical Center, 8700 Beverly Blvd #AC-1020, Los Angeles, CA, 90048-1865, USA

    C. Michele Burnison

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Correspondence to C. Michele Burnison .

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  1. Department of Medicine, The James R. Klinenberg M.D. Chair in Me, Professor and Chairman,, Cedars-Sinai Medical Center, Los Angeles, 90048, California, USA

    Glenn D. Braunstein

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Burnison, C.M. (2012). External Beam Radiation Therapy in the Treatment of Differentiated Thyroid Cancers. In: Braunstein, G. (eds) Thyroid Cancer. Endocrine Updates, vol 32. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-0875-8_14

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