Application of intensity-modulated radiotherapy in unresectable poorly differentiated thyroid carcinoma

Abstract

Poorly differentiated thyroid carcinoma (PDTC) is a rare and aggressive malignancy with high rates of invasion and distant metastasis. This study was to explore the ability of intensity-modulated radiotherapy (IMRT) combined with chemotherapy to manage unresectable PDTC. Between February 2011 and April 2012, 5 patients with unresectable PDTC were treated by IMRT at our institution and were included in this analysis. The median radiotherapy dose to the gross tumor volume (GTV) was 66 Gy/33 fractions/6.4 weeks. All patients received chemotherapy, and one patient with tumor compression symptoms had a tracheotomy before treatment. The mean survival time of the 5 patients was 41.6 months. The direct causes of death were distant metastases (40%) and progression of the locoregional disease (20%). In conclusion, IMRT combined with chemotherapy for unresectable PDTC might be beneficial to improve locoregional control. Further new therapies are needed to control metastases.

The Long Journey towards Personalized Targeted Therapy in Poorly Differentiated Thyroid Carcinoma (PDTC): A Case Report and Systematic Review

“…In the majority of studies in our review, the extent of the poorly differentiated area was not reported, and a PDTC definition was decided to address this component. A large number of patients with PDTC reviewed herein presented with locally advanced disease (T3 or T4, extrathyroidal extension, and nodal involvement) [ 40 , 44 , 46 , 47 , 49 , 50 , 51 , 54 , 55 , 57 , 58 , 60 , 61 , 62 , 64 , 67 , 68 , 69 , 70 , 71 , 73 , 74 , 75 , 76 , 77 , 78 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 90 , 91 , 92 , 94 , 97 , 98 , 99 , 100 , 101 , 102 , 107 , 108 , 109 , 111 , 112 , 113 , 114 , 115 , 116 ,…”

“…At present, there is no effective targeted chemotherapeutic regime for PDTC. Cisplatin/doxorubicin and carboplatin/paclitaxel are similar combinations that are used to modulate disease progression, and likewise, only a few of the revised studies used these schemes for select patients [ 42 , 57 , 60 , 78 , 97 , 114 , 119 ].…”