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Clinical outcome of anaplastic thyroid carcinoma treated with radiotherapy of once- and twice-daily fractionation regimens Wang Y; Tsang R; Asa S; Dickson B; Arenovich T; Brierley JCancer 2006[Oct]; 107 (8): 1786-92BACKGROUND: 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 < or = 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.|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Carcinoma/mortality/*radiotherapy[MESH]|Disease Progression[MESH]|Dose Fractionation, Radiation[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Radiation Injuries/epidemiology[MESH]|Radiotherapy Dosage[MESH]|Retrospective Studies[MESH]|Salvage Therapy[MESH]|Survival Analysis[MESH]|Thyroid Neoplasms/mortality/*radiotherapy[MESH]|Treatment Outcome[MESH] |
