title: Intensity-modulated radiation therapy for the treatment of nonanaplastic thyroid cancer.
abstract: OBJECTIVE
  Intensity-modulated radiation therapy (IMRT) enables highly conformal treatment for thyroid cancer (TC). In this study, we review outcomes/toxicity in a series of TC patients treated with IMRT.
  
  
  METHODS
  Between July 2001 and January 2004, 20 nonanaplastic TC patients underwent IMRT. Mean age was 55. There were 3 T2 and 17 T4 patients. Sixteen patients had N1 disease. Seven patients had metastases before RT. Fifteen underwent surgery before RT. Radioactive iodine (RAI) and chemotherapy were used in 70% and 40%, respectively. Median total RT dose was 63 Gy.
  
  
  RESULTS
  With two local failures, 2-year local progression-free rate was 85%. There were six deaths, with a 2-year overall survival rate of 60%. For patients with M0 disease, the 2-year distant metastases-free rate was 46%. The worst acute mucositis and pharyngitis was Grade 3 (n = 7 and 3, respectively). Two patients had Grade 3 acute skin toxicity and 2 had Grade 3 acute laryngeal toxicity. No significant radiation-related late effects were reported.
  
  
  CONCLUSIONS
  IMRT for TC is feasible and effective in appropriately selected cases. Acute toxicity is manageable with proactive clinical care. Ideal planning target volume doses have yet to be determined. Additional patients and long-term follow-up are needed to confirm these preliminary findings and to clarify late toxicities.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Rosenbluth
authors.forename: Victoria
authors.initials: V
authors.lastname: Serrano
authors.forename: Laura
authors.initials: L
authors.lastname: Happersett
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Shaha
authors.forename: R Michael
authors.initials: RM
authors.lastname: Tuttle
authors.forename: Ashwatha
authors.initials: A
authors.lastname: Narayana
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Wolden
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Rosenzweig
authors.forename: Lanceford M
authors.initials: LM
authors.lastname: Chong
authors.forename: Nancy Y
authors.initials: NY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018276:Carcinoma, Medullary / Q000532:radiotherapy; D002291:Carcinoma, Papillary / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D013964:Thyroid Neoplasms / Q000532:radiotherapy*; D016896:Treatment Outcome