Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer.

IF 3 3区 医学 Q2 ONCOLOGY
International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-05-30 DOI:10.1080/02656736.2024.2358054
Chung-Shih Chen, Sheng-Dean Luo, Yen-Hsiang Chang, Chen Kai Chou, Shun-Yu Chi, Shao-Chun Wu, Yen-Hao Chen, Johnson Chia-Shen Yang, Eng-Yen Huang, Yu-Ming Wang, Wei-Che Lin
{"title":"Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer.","authors":"Chung-Shih Chen, Sheng-Dean Luo, Yen-Hsiang Chang, Chen Kai Chou, Shun-Yu Chi, Shao-Chun Wu, Yen-Hao Chen, Johnson Chia-Shen Yang, Eng-Yen Huang, Yu-Ming Wang, Wei-Che Lin","doi":"10.1080/02656736.2024.2358054","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The treatment of recurrent thyroid cancer with critical organ invasion is challenging. The combination of radiofrequency ablation (RFA) and external beam radiation therapy (EBRT) has been proposed as an effective option. This study evaluates outcomes for inoperable residual/recurrent differentiated thyroid cancer (rDTC) patients treated with RFA followed by EBRT.</p><p><strong>Materials and methods: </strong>Patients with rDTC treated with RFA followed by EBRT were retrospectively studied. RFA was performed using a free-hand, 'moving-shot' technique under US or CT guidance. For lesions invading critical structures intolerant to 'en bloc' high-temperature RFA, limited-field EBRT using 6- or 10-MV photons was used for adjuvant treatment at a dose of 66 Gy in 33 daily fractions. Toxicities and outcomes were reviewed.</p><p><strong>Results: </strong>Between April 2020 and January 2022, 11 patients with 14 rDTC lesions underwent RFA followed by EBRT. Five patients had metastatic lesions at rDTC diagnosis. With a median follow-up period of 33.7 months, all patients maintained locoregional control, while achieving a 2-year survival rate of 90.9%. This combined treatment achieved a volume reduction ratio of 92.1% ± 5.1%. The mean nadir thyroglobulin level in patients without initial distant metastases after treatment was 1.40 ± 0.81 ng/ml. Regarding treatment-related complications, one patient (9%) experienced temporary hoarseness after RFA, grade 2 radiation dermatitis occurred in 3 patients (27.2%), and grade 2 dysphagia was noted in 4 patients (36.4%). No grade 3 or greater toxicities occurred.</p><p><strong>Conclusions: </strong>Salvage RFA followed by EBRT is feasible, effective and safe for patients with rDTC.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Hyperthermia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02656736.2024.2358054","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: The treatment of recurrent thyroid cancer with critical organ invasion is challenging. The combination of radiofrequency ablation (RFA) and external beam radiation therapy (EBRT) has been proposed as an effective option. This study evaluates outcomes for inoperable residual/recurrent differentiated thyroid cancer (rDTC) patients treated with RFA followed by EBRT.

Materials and methods: Patients with rDTC treated with RFA followed by EBRT were retrospectively studied. RFA was performed using a free-hand, 'moving-shot' technique under US or CT guidance. For lesions invading critical structures intolerant to 'en bloc' high-temperature RFA, limited-field EBRT using 6- or 10-MV photons was used for adjuvant treatment at a dose of 66 Gy in 33 daily fractions. Toxicities and outcomes were reviewed.

Results: Between April 2020 and January 2022, 11 patients with 14 rDTC lesions underwent RFA followed by EBRT. Five patients had metastatic lesions at rDTC diagnosis. With a median follow-up period of 33.7 months, all patients maintained locoregional control, while achieving a 2-year survival rate of 90.9%. This combined treatment achieved a volume reduction ratio of 92.1% ± 5.1%. The mean nadir thyroglobulin level in patients without initial distant metastases after treatment was 1.40 ± 0.81 ng/ml. Regarding treatment-related complications, one patient (9%) experienced temporary hoarseness after RFA, grade 2 radiation dermatitis occurred in 3 patients (27.2%), and grade 2 dysphagia was noted in 4 patients (36.4%). No grade 3 or greater toxicities occurred.

Conclusions: Salvage RFA followed by EBRT is feasible, effective and safe for patients with rDTC.

对无法手术的复发性分化型甲状腺癌进行抢救性射频消融,然后进行体外放射治疗。
目的:复发性甲状腺癌伴有重要器官侵犯的治疗具有挑战性。射频消融(RFA)和体外放射治疗(EBRT)的结合被认为是一种有效的选择。本研究评估了无法手术的残留/复发分化型甲状腺癌(rDTC)患者接受射频消融术和EBRT治疗后的疗效:回顾性研究了接受RFA和EBRT治疗的rDTC患者。在 US 或 CT 引导下,采用徒手 "移动射击 "技术进行 RFA。对于不能耐受 "整体 "高温RFA的侵犯重要结构的病灶,采用6或10-MV光子的有限场EBRT进行辅助治疗,剂量为66 Gy,每天分33次进行。结果:2020年4月至2022年1月期间,11名患者的14个rDTC病灶接受了RFA治疗,随后接受了EBRT治疗。5名患者在确诊为rDTC时已有转移病灶。中位随访时间为 33.7 个月,所有患者均保持了局部控制,2 年生存率达到 90.9%。联合治疗的体积缩小率为92.1% ± 5.1%。治疗后无远处转移的患者的甲状腺球蛋白平均水平为(1.40 ± 0.81)纳克/毫升。在治疗相关并发症方面,1例患者(9%)在RFA治疗后出现暂时性声音嘶哑,3例患者(27.2%)出现2级放射性皮炎,4例患者(36.4%)出现2级吞咽困难。没有出现3级或更严重的毒性反应:抢救性 RFA 后进行 EBRT 对 rDTC 患者是可行、有效和安全的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信