核医学と放射線治療

Results of Intensity Modulated Radiation Therapy in Patients with Well Differentiated Thyroid Carcinoma: Experience of King Fahad Medical City

Abstract

Mushabbab AlAsiri, Mutahir Ali Tunio, Abdullah Amro, Shoaib Ahmad, Yasser Bayoumi and Mohsin Fareed

Background: We aimed to evaluate the outcomes and toxicity profile in patients with well differentiated thyroid carcinoma (WDTC) treated with intensity modulated radiation therapy (IMRT). Materials and methods: Between June 2007 and July 2011, 18 patients with WDTC received postoperative IMRT with mean radiation dose 66Gy (60-66) delivered with 7 dynamic beams. Median age was 50.5 years (23-66); of whom 10 were males (55.6%) and 8 were females (44.4%). Predominant histology was papillary in 17 patients (94.4%) and predominant T stage was T4 in 15 patients (83.3%). RAI therapy was given to all patients. Results: Median follow up was 53 months (6-55). At 48 months, the Kaplan-Meier estimates of locoregional control, distant control and overall survival were 88.9%, 83.2% and 89.4% respectively. Incomplete surgery, presence of lymphovascular invasion (LVI), and number of >4 positive lymph nodes were found as poor prognostic factors (0.0001). Acute grade 3 Mucositis was experienced in one patient (5.5%) and grade 3 skin toxicity was seen in 1 patient (5.5%). Late toxicities were few and of grade 2. Conclusion: Postoperative IMRT offers excellent locoregional and distant control rates and overall survival with minimal toxicity profile in the treatment of WDTC.