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Clinical outcome of anaplastic thyroid carcinoma treated with radiotherapy of once- and twice-daily fractionation regimens

  1. Yongjin Wang MD1,
  2. Richard Tsang MD1,
  3. Sylvia Asa MD, PhD2,
  4. Brendan Dickson MD2,
  5. Tamara Arenovich MSc3,
  6. James Brierley MB1,†,*

Article first published online: 11 SEP 2006

DOI: 10.1002/cncr.22203

Issue

Cancer

Cancer

Volume 107, Issue 8, pages 1786–1792, 15 October 2006

Additional Information

How to Cite

Wang, Y., Tsang, R., Asa, S., Dickson, B., Arenovich, T. and Brierley, J. (2006), Clinical outcome of anaplastic thyroid carcinoma treated with radiotherapy of once- and twice-daily fractionation regimens. Cancer, 107: 1786–1792. doi: 10.1002/cncr.22203

Author Information

  1. 1

    Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada

  2. 2

    Department of Pathology, Princess Margaret Hospital, Toronto, Ontario, Canada

  3. 3

    Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario, Canada

  1. †

    Fax: (416) 946-6566.

*Department of Radiation Oncology, Princess Margaret Hospital, 610 University Ave., Rm. 5-627, Toronto, ON M5G 2M9 Canada

Publication History

  1. Issue published online: 3 OCT 2006
  2. Article first published online: 11 SEP 2006
  3. Manuscript Accepted: 10 JUL 2006
  4. Manuscript Revised: 28 JUN 2006
  5. Manuscript Received: 2 MAY 2006

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Keywords:

  • anaplastic thyroid carcinoma;
  • external beam radiotherapy;
  • twice-daily fractionation;
  • local control;
  • survival

Abstract

BACKGROUND

The purpose was to assess local control, survival, and toxicity after radiotherapy in patients with anaplastic thyroid carcinoma, and to compare clinical outcomes between once-daily and twice-daily fractionation regimens.

METHODS

A retrospective review of patients with anaplastic thyroid carcinoma (n = 47) who underwent external beam radiotherapy from 1983 to 2004 was conducted. Twenty-three patients underwent radical radiotherapy with a radiation dose >40 Gy, and 24 patients underwent palliative radiotherapy with a dose ≤40 Gy. Of radical radiotherapy, radiation was given with once-daily (14 patients) or twice-daily fractionation (9 patients; 1.5 Gy per fraction) to a total dose of 45–66 Gy. Most patients (37 patients; 78.7%) were followed to death.

RESULTS

The 6-month local progression-free rate in patients who underwent radical radiotherapy was 94.1%, significantly higher compared with palliative radiotherapy (64.6%; P = .02). The median actuarial overall survival was greater in patients with radical radiotherapy (11.1 months) compared with palliative radiotherapy (3.2 months; P < .0001). The median overall survival in patients with twice-daily fractionation (13.6 months) was 3.3 months longer than patients treated with once-daily fractionation (10.3 months), but the difference was not statistically significant (P = .3). For patients treated with twice-daily fractionation, 3 patients had Grade 3 acute skin toxicity, and no patient had Grade 3 or higher esophageal toxicity.

CONCLUSIONS

Radiotherapy can result in local control of anaplastic thyroid carcinoma. A twice-daily fractionation regimen is well tolerated and has a trend to longer survival, which deserves a larger study. Cancer 2006. © 2006 American Cancer Society.

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