Intraoperative radiation therapy, endotracheal hyperthermia and IR-192-brachytherapy in patients with advanced thyroid cancer.
Tracheal stenosis due to infiltrative nonresectable thyroid cancer causes severe reduction in life quality. Palliative therapy, apart from tracheostomy is--up to now--intraluminal and/or external radiation. Good tumor control is achieved by local hyperthermia. A combined modality treatment (CMT) consisting of surgery, brachytherapy and intraoperative radiation, eventually combined with intraluminal NdYg-Laser-desobliteration was performed. An intraoperative radiation therapy (IORT)-protocol was designed for poorly differentiated non-anaplastic thyroid carcinoma. Out of 155 cases of differentiated thyroid tumors, 12 showed marked vascular and/or capsular invasion. Five entered the study (3 primarily local invasive tumors, 2 local recurring). IORT was administered after tumor surgery (4-10 Gy) and combined with postoperative percutaneous irradiation. The tumor control rate in the thyroid bed is 5/5, 1/5 developed mediastinal nodes, 1/5 with primary mediastinal tumor extend shows tumor progression. No specific complications occurred.
Wolf
G
G
Division of Endocrine Surgery, Karl-Franzens-University, Graz, Austria.
Kohek
P
P
Geyer
E
E
Pakisch
B
B
Langsteger
W
W
Ramschak
S
S
Passath
A
A
D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D001918:Brachytherapy / Q000295:instrumentation*; D002291:Carcinoma, Papillary / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D053685:Laser Therapy / Q000295:instrumentation; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010166:Palliative Care; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D014135:Tracheal Stenosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery