External beam radiotherapy for thyroid cancer: Patients, complications, and survival

Am J Surg. 2023 Jun;225(6):994-999. doi: 10.1016/j.amjsurg.2023.01.009. Epub 2023 Jan 11.

Abstract

Background: Patterns of utilization of external beam radiation therapy (EBRT) in thyroid cancer are incompletely described. We characterize therapeutic intent, complications, and survival in thyroid cancer treated with EBRT.

Methods: In this retrospective study of 105 thyroid cancer patients treated with EBRT at one institution (2008-2018), the primary outcome was overall survival. Secondary outcomes included incomplete treatment, emergency department (ED) visits, weight change, and gastrostomy placement.

Results: Dominant histopathology was differentiated (44%), anaplastic (45%) and poorly-differentiated (11%) disease. EBRT was mainly utilized for locoregional control (differentiated 87%, poorly-differentiated 75%, anaplastic 92%). Palliative EBRT was more common in poorly-differentiated disease (42%). Weight loss was greater in aggressive/advanced disease (differentiated 10 lb, poorly-differentiated 27 lb, anaplastic 18 lb). Anaplastic cancer had higher rates of gastrostomy (34%) and lowest rates of treatment completion (83%). ED encounters were common (differentiated 44%, poorly-differentiated 50%, anaplastic 45%). Gastrostomy was associated with mortality on multivariable analysis in non-anaplastic malignancy.

Conclusions: EBRT was most frequently administered for locoregional control in thyroid cancer. Despite complications, the majority of patients completed EBRT therapy.

Keywords: Complications; External beam radiation therapy; Thyroid cancer.

MeSH terms

  • Humans
  • Radiotherapy
  • Retrospective Studies
  • Thyroid Neoplasms* / radiotherapy
  • Thyroid Neoplasms* / surgery