External‐beam radiotherapy for differentiated thyroid cancer locoregional control: A statement of the American Head and Neck Society

The use of external‐beam radiotherapy (EBRT) in differentiated thyroid cancer (DTC) is debated because of a lack of prospective clinical data, but recent retrospective studies have reported benefits in selected patients. The Endocrine Surgery Committee of the American Head and Neck Society provides 4 recommendations regarding EBRT for locoregional control in DTC, based on review of literature and expert opinion of the authors. (1) EBRT is recommended for patients with gross residual or unresectable locoregional disease, except for patients <45 years old with limited gross disease that is radioactive iodine (RAI)‐avid. (2) EBRT should not be routinely used as adjuvant therapy after complete resection of gross disease. (3) After complete resection, EBRT may be considered in select patients >45 years old with high likelihood of microscopic residual disease and low likelihood of responding to RAI. (4) Cervical lymph node involvement alone should not be an indication for adjuvant EBRT. © 2015 Wiley Periodicals, Inc. Head Neck 38: 493–498, 2016

[1]  M. Papotti,et al.  Poorly differentiated carcinomas of the thyroid with trabecular, insular, and solid patterns , 2004, Cancer.

[2]  K. Rosenzweig,et al.  Intensity-modulated radiation therapy for the treatment of nonanaplastic thyroid cancer. , 2005, International journal of radiation oncology, biology, physics.

[3]  J. Tward,et al.  The risk of second primary malignancies up to three decades after the treatment of differentiated thyroid cancer. , 2008, The Journal of clinical endocrinology and metabolism.

[4]  J. Friedberg,et al.  Second malignancy after Hodgkin disease treated with radiation therapy with or without chemotherapy: long-term risks and risk factors. , 2002, Blood.

[5]  D. Johnston,et al.  The results of various modalities of treatment of well differentiated thyroid carcinomas: a retrospective review of 1599 patients. , 1992, The Journal of clinical endocrinology and metabolism.

[6]  S. Larson,et al.  Radioactive iodine administered for thyroid remnant ablation following recombinant human thyroid stimulating hormone preparation also has an important adjuvant therapy function. , 2010, Thyroid : official journal of the American Thyroid Association.

[7]  H. Sack,et al.  Differentiated thyroid cancer: Impact of adjuvant external radiotherapy in patients with perithyroidal tumor infiltration (stage pT4) , 1996, Cancer.

[8]  P. Hall,et al.  Second primary malignancies in thyroid cancer patients , 2003, British Journal of Cancer.

[9]  J. Carpten,et al.  Whole-genome Sequencing of an Aggressive BRAF Wild-type Papillary Thyroid Cancer Identified EML4–ALK Translocation as a Therapeutic Target , 2014, World Journal of Surgery.

[10]  C. Kwan,et al.  Local and regional control in patients with papillary thyroid carcinoma: specific indications of external radiotherapy and radioactive iodine according to T and N categories in AJCC 6th edition. , 2006, Endocrine-related cancer.

[11]  Sung-Bae Kim,et al.  Lenvatinib versus placebo in radioiodine-refractory thyroid cancer. , 2015, The New England journal of medicine.

[12]  J. Shah,et al.  The impact of microscopic extrathyroid extension on outcome in patients with clinical T1 and T2 well-differentiated thyroid cancer. , 2011, Surgery.

[13]  Tae Yong Kim,et al.  Clinical features and prognostic factors for survival in patients with poorly differentiated thyroid carcinoma and comparison to the patients with the aggressive variants of papillary thyroid carcinoma. , 2007, Endocrine journal.

[14]  N. Willich,et al.  Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer , 2009, Nuklearmedizin.

[15]  R. Tsang,et al.  Prognostic factors and the effect of treatment with radioactive iodine and external beam radiation on patients with differentiated thyroid cancer seen at a single institution over 40 years , 2005, Clinical endocrinology.

[16]  K. Keum,et al.  The role of postoperative external-beam radiotherapy in the management of patients with papillary thyroid cancer invading the trachea. , 2006, International journal of radiation oncology, biology, physics.

[17]  E. Kandil,et al.  Management of invasive well‐differentiated thyroid cancer: An American head and neck society consensus statement: AHNS consensus statement , 2014, Head & neck.

[18]  B. Goh,et al.  Efficacy of pazopanib in progressive, radioiodine-refractory, metastatic differentiated thyroid cancers: results of a phase 2 consortium study. , 2010, The Lancet. Oncology.

[19]  S. Larson,et al.  Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. , 2000, The Journal of clinical endocrinology and metabolism.

[20]  N. Lee,et al.  External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non‐anaplastic non‐medullary thyroid cancer , 2014, Journal of surgical oncology.

[21]  R. Paschke,et al.  Sorafenib in radioactive iodine-refractory, locally advanced or metastatic differentiated thyroid cancer: a randomised, double-blind, phase 3 trial , 2014, The Lancet.

[22]  Stephanie L. Lee,et al.  Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. , 2009, Thyroid : official journal of the American Thyroid Association.

[23]  M. Zelefsky,et al.  Role of external beam radiotherapy in patients with advanced or recurrent nonanaplastic thyroid cancer: Memorial Sloan-kettering Cancer Center experience. , 2009, International journal of radiation oncology, biology, physics.

[24]  G. Wiseman,et al.  Lack of impact of radioiodine therapy in tg-positive, diagnostic whole-body scan-negative patients with follicular cell-derived thyroid cancer. , 2002, The Journal of clinical endocrinology and metabolism.

[25]  C. McConkey,et al.  External beam radiotherapy in the management of differentiated thyroid cancer. , 2003, Clinical oncology (Royal College of Radiologists (Great Britain)).

[26]  J. Chapelon,et al.  High-intensity focused ultrasound ablation of thyroid nodules: first human feasibility study. , 2011, Thyroid : official journal of the American Thyroid Association.

[27]  E. Baudin,et al.  Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. , 2006, The Journal of clinical endocrinology and metabolism.

[28]  Jeong Hyun Lee,et al.  Radiofrequency and ethanol ablation for the treatment of recurrent thyroid cancers: current status and challenges , 2013, Current opinion in oncology.

[29]  J. Bishop,et al.  Highly prevalent TERT promoter mutations in aggressive thyroid cancers. , 2013, Endocrine-related cancer.

[30]  M. Schlumberger,et al.  External radiotherapy in thyroid cancers , 1985, Cancer.

[31]  K. Jung,et al.  Value of external irradiation for locally advanced papillary thyroid cancer. , 2003, International journal of radiation oncology, biology, physics.

[32]  M. Perrino,et al.  Ultrasound-guided percutaneous ethanol injection in papillary thyroid cancer metastatic lymph-nodes , 2014, Endocrine.

[33]  A. Shaha Implications of Prognostic Factors and Risk Groups in the Management of Differentiated Thyroid Cancer , 2004, The Laryngoscope.

[34]  R. A’Hern,et al.  Results of external beam radiotherapy in differentiated thyroid carcinoma: a retrospective study from the Royal Marsden Hospital. , 1994, European journal of cancer.

[35]  A. Garden,et al.  Postoperative external beam radiotherapy for differentiated thyroid cancer: outcomes and morbidity with conformal treatment. , 2009, International journal of radiation oncology, biology, physics.

[36]  J. Jonklaas,et al.  Outcomes of patients with differentiated thyroid carcinoma following initial therapy. , 2006, Thyroid : official journal of the American Thyroid Association.

[37]  P. Grigsby,et al.  Combined [18F]Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography (FDG-PET/CT) for Detection of Recurrent, 131I-Negative Thyroid Cancer , 2007, Annals of Surgical Oncology.

[38]  N. Lee,et al.  Target Volume Delineation and Field Setup , 2013 .

[39]  S. Larson,et al.  Resistance of [18f]-fluorodeoxyglucose-avid metastatic thyroid cancer lesions to treatment with high-dose radioactive iodine. , 2001, Thyroid : official journal of the American Thyroid Association.

[40]  K. Ahn,et al.  Radiofrequency Ablation to Treat Loco-Regional Recurrence of Well-Differentiated Thyroid Carcinoma , 2014, Korean journal of radiology.

[41]  A. Stojadinovic,et al.  Impact of degree of extrathyroidal extension of disease on papillary thyroid cancer outcome. , 2014, Thyroid : official journal of the American Thyroid Association.

[42]  D. Dupuy,et al.  Image-guided ablation of postsurgical locoregional recurrence of biopsy-proven well-differentiated thyroid carcinoma. , 2013, Journal of vascular and interventional radiology : JVIR.

[43]  G. Sheline,et al.  Radiation therapy in the control of persistent thyroid cancer. , 1966, The American journal of roentgenology, radium therapy, and nuclear medicine.

[44]  P. Ladenson,et al.  Association between BRAF V600E mutation and mortality in patients with papillary thyroid cancer. , 2013, JAMA.

[45]  Jeong Hyun Lee,et al.  Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer , 2014, European Radiology.

[46]  L. Kowalski,et al.  Results of the treatment of locally invasive thyroid carcinoma , 2002, Head & neck.

[47]  H. Marres,et al.  The management of thyroid carcinoma invading the larynx or trachea , 2010, The Laryngoscope.

[48]  R. Weber,et al.  Patterns of lateral neck metastasis in papillary thyroid carcinoma. , 2004, Archives of otolaryngology--head & neck surgery.

[49]  A. Gafni,et al.  An updated systematic review and commentary examining the effectiveness of radioactive iodine remnant ablation in well-differentiated thyroid cancer. , 2008, Endocrinology and metabolism clinics of North America.

[50]  S. Jhiang,et al.  Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. , 1994, The American journal of medicine.

[51]  J. Maurice,et al.  Bilateral radical neck dissection with unilateral internal jugular vein reconstruction , 1998, The Laryngoscope.

[52]  Ling-Feng Wang,et al.  Thyroid tumors with preoperative recurrent laryngeal nerve palsy: clinicopathologic features and treatment outcome. , 2006, Surgery.

[53]  Parisha Bhatia,et al.  Percutaneous ethanol injection vs reoperation for locally recurrent papillary thyroid cancer: a systematic review and pooled analysis. , 2015, JAMA otolaryngology-- head & neck surgery.

[54]  J. Ricarte-Filho,et al.  Molecular, morphologic, and outcome analysis of thyroid carcinomas according to degree of extrathyroid extension. , 2010, Thyroid : official journal of the American Thyroid Association.

[55]  M. Hafermann External radiotherapy. , 1981, Urology.

[56]  Joo Ha Hwang,et al.  Emerging HIFU applications in cancer therapy , 2015, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[57]  N. Lee,et al.  A risk-adapted approach to the use of radioactive iodine and external beam radiation in the treatment of well-differentiated thyroid cancer. , 2011, Cancer control : journal of the Moffitt Cancer Center.

[58]  H. Matsuda,et al.  Preservation of recurrent laryngeal nerve invaded by differentiated thyroid cancer. , 1997, Annals of surgery.