External beam radiotherapy for thyroid cancer: Patients, complications, and survival.

Complications External beam radiation therapy Thyroid cancer

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
06 2023
Historique:
received: 12 10 2022
revised: 10 12 2022
accepted: 08 01 2023
medline: 30 5 2023
pubmed: 28 1 2023
entrez: 27 1 2023
Statut: ppublish

Résumé

Patterns of utilization of external beam radiation therapy (EBRT) in thyroid cancer are incompletely described. We characterize therapeutic intent, complications, and survival in thyroid cancer treated with EBRT. In this retrospective study of 105 thyroid cancer patients treated with EBRT at one institution (2008-2018), the primary outcome was overall survival. Secondary outcomes included incomplete treatment, emergency department (ED) visits, weight change, and gastrostomy placement. Dominant histopathology was differentiated (44%), anaplastic (45%) and poorly-differentiated (11%) disease. EBRT was mainly utilized for locoregional control (differentiated 87%, poorly-differentiated 75%, anaplastic 92%). Palliative EBRT was more common in poorly-differentiated disease (42%). Weight loss was greater in aggressive/advanced disease (differentiated 10 lb, poorly-differentiated 27 lb, anaplastic 18 lb). Anaplastic cancer had higher rates of gastrostomy (34%) and lowest rates of treatment completion (83%). ED encounters were common (differentiated 44%, poorly-differentiated 50%, anaplastic 45%). Gastrostomy was associated with mortality on multivariable analysis in non-anaplastic malignancy. EBRT was most frequently administered for locoregional control in thyroid cancer. Despite complications, the majority of patients completed EBRT therapy.

Sections du résumé

BACKGROUND
Patterns of utilization of external beam radiation therapy (EBRT) in thyroid cancer are incompletely described. We characterize therapeutic intent, complications, and survival in thyroid cancer treated with EBRT.
METHODS
In this retrospective study of 105 thyroid cancer patients treated with EBRT at one institution (2008-2018), the primary outcome was overall survival. Secondary outcomes included incomplete treatment, emergency department (ED) visits, weight change, and gastrostomy placement.
RESULTS
Dominant histopathology was differentiated (44%), anaplastic (45%) and poorly-differentiated (11%) disease. EBRT was mainly utilized for locoregional control (differentiated 87%, poorly-differentiated 75%, anaplastic 92%). Palliative EBRT was more common in poorly-differentiated disease (42%). Weight loss was greater in aggressive/advanced disease (differentiated 10 lb, poorly-differentiated 27 lb, anaplastic 18 lb). Anaplastic cancer had higher rates of gastrostomy (34%) and lowest rates of treatment completion (83%). ED encounters were common (differentiated 44%, poorly-differentiated 50%, anaplastic 45%). Gastrostomy was associated with mortality on multivariable analysis in non-anaplastic malignancy.
CONCLUSIONS
EBRT was most frequently administered for locoregional control in thyroid cancer. Despite complications, the majority of patients completed EBRT therapy.

Identifiants

pubmed: 36707300
pii: S0002-9610(23)00010-7
doi: 10.1016/j.amjsurg.2023.01.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

994-999

Informations de copyright

Copyright © 2023. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare they have no conflicts of interest.

Auteurs

Kristin Goodsell (K)

University of Washington, Department of Surgery, Seattle, WA, 98195, USA.

Jae Ermer (J)

Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia, PA, 19104, USA.

Wajid Amjad (W)

Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia, PA, 19104, USA.

Samuel Swisher-McClure (S)

Beebe Healthcare, Department of Radiation Oncology, Rehoboth Beach, DE, 19971, USA.

Heather Wachtel (H)

Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia, PA, 19104, USA; Perelman School of Medicine, Philadelphia, PA, 19104, USA. Electronic address: Heather.Wachtel@pennmedicine.upenn.edu.

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Classifications MeSH