ANAPLASTIC THYROID CANCER: CLINICAL OUTCOMES WITH CONFORMAL RADIOTHERAPY

Background. The aim of this study was to review institutional outcomes for anaplastic thyroid cancer treated with conformal 3-dimensional radiotherapy (3DRT) or intensity-modulated radiotherapy (IMRT). Methods. In all, 53 consecutive patients were analyzed. Thirty-one (58%) patients were irradiated with curative intent. Median radiation dose was 55 Gray (Gy; range, 4-70 Gy). Thirteen (25%) patients received IMRT to a median 60 Gy (range, 39.9-69.0 Gy). Thirty-nine (74%) patients received chemotherapy with radiation. Results. The Kaplan-Meier estimate of overall survival (OS) at 1 year for definitively irradiated patients was 29%. Patients without distant metastases receiving >= 50 Gy had superior survival outcomes; 5 such patients had no evidence of disease at last follow-up. Use of IMAT versus 3DRT did not influence toxicity. Conclusions. Outcomes for anaplastic thyroid cancer treated with 3DRT or IMRT remain equivalent to historical results. Healthy patients with localized disease who tolerate full dose irradiation can potentially enjoy prolonged survival. Biologically targeted radiosensitization merits prioritized investigation. (c) 2009 Wiley Periodicals, Inc. Head Neck 32: 829-836, 2010