Efficacité et tolérance de la radiothérapie externe pour les patients atteints d'une récidive d'un carcinome différencié de la thyroïde |
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| Institution: | 1. AP–HP, hôpital universitaire Pitié-Salpêtrière, service d’oncologie radiothérapie, 47–83, boulevard de l’Hôpital, 75651 Paris cedex 13, France;2. Université de Paris, institut Cochin, Inserm, CNRS, 22, rue Méchain, 75014 Paris, France;3. AP–HP, hôpital universitaire Pitié-Salpêtrière, service d’oncologie médicale, 47–83, boulevard de l’Hôpital, 75651 Paris cedex 13, France;1. Department of radiotherapy, institut de cancérologie de Lorraine, 54519 Vand?uvre-lès-Nancy, France;2. Faculté de médecine de Nancy, université de Lorraine, 9, avenue de la Forêt de Haye, 54505 Vand?uvre-lès-Nancy, France;3. Biostatistic unit, institut de cancérologie de Lorraine, 54519 Vand?uvre-lès-Nancy, France;1. Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy;2. Medical Physics, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy;3. Department of Clinical, Surgical, Diagnostic & Pediatric Sciences, University of Pavia, Pavia, Italy;4. General Surgery Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;1. Department of radiation oncology, Gustave Roussy Cancer Campus, université Paris-Saclay, 94805 Villejuif, France;2. Department of pediatric surgery, Kremlin-Bicêtre university hospital, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France;3. Department of pediatric oncology, Gustave Roussy, université Paris-Saclay, 94805 Villejuif, France;1. Service de radiothérapie, Institut de cancérologie de Lorraine, route de Bourgogne, 54519 Vand?uvre-les-Nancy, France;2. Service de biostatistique, Institut de cancérologie de Lorraine, route de Bourgogne, 54519 Vand?uvre-les-Nancy, France;3. Service de radiothérapie, Centre Paul-Strauss, 3, rue de la Porte de l’Hôpital, 67000 Strasbourg, France;4. Service de radiothérapie, Centre GF-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France;5. Service de radiothérapie, Institut Claudius-Regaud, IUCT-Oncopole, 20-24, rue du Pont Saint-Pierre, 31300 Toulouse, France;6. Service de radiothérapie, Institut Bergonié, 229, Cours de l’Argonne, 33000 Bordeaux, France;7. Service de radiothérapie, Centre Léon-Berard, 28, Prom.-Léa-et-Napoléon-Bullukian, 69008 Lyon, France;8. Service de radiothérapie, CHRU de Tours, Hôpital Bretonneau, 2, boulevard Tonnellé, 37000 Tours, France |
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| Abstract: | PurposeRadiation therapy is often the last resource treatment for cervical relapse in iodine refractory differentiated thyroid cancer. We present locoregional control data in patients with cervical relapse treated with curative intent radiation therapy with or without concomitant carboplatin.Material and methodsThis monocentric retrospective study gathered data on patients with differentiated thyroid carcinoma – vesicular or papillary – in relapse after thyroidectomy who received a curative intent cervical radiation therapy. Locoregional progression free survival (LRPFS), progression free survival (PFS), overall survival (OS) were gathered as well as acute and chronic adverse events assessed with the CTCAE v4.ResultsThirty-nine patients were consecutively included between 2005 and 2019. The median follow-up was 36.6 months. Fifteen patients (38%) had a locoregional relapse, locoregional control at 2 years was 66.7%. The median LRPFS was 48 months 32.9–not reached] and the median overall survival 49 months 38.8–not reached]. In multivariate analysis, initial incomplete resection was associated with poorer OS (HR: 24.39 3.57–166.78], P = 0.00113) and LRPFS (HR: 33.91 4.46–257.61], P = 0.00066), extra nodal spread was associated with poorer LRPFS (HR: 13.45 1.81–99,76], P = 0.011). ECOG performance status was associated with OS (HR: 5.11 1.57–16.66], P = 0.00688). Carboplatin association with radiation therapy was not associated with improved survivals (OS: P = 0.34, LRPFS: P = 0.84). The rate of acute grade 3 toxicities was 14%.ConclusionSalvage cervical radiation therapy was associated with a locoregional control of 66.7% at 2 years with a reasonable toxicity rate. Carboplatin association with radiation therapy did not improve locoregional control nor overall survival in comparison with radiotherapy alone. |
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| Keywords: | Thyroid carcinoma Thyroid cancer Iodine refractory External radiotherapy Chemoradiotherapy |
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