The role of postoperative external-beam radiotherapy in the management of patients with papillary thyroid cancer invading the trachea.
OBJECTIVE
To determine the role of adjuvant external-beam radiotherapy (EBRT) in the management of patients with well-differentiated thyroid cancer invading the trachea.


METHODS
Of 1,098 thyroid cancer patients, 68 (6%) were found to have tracheal invasion, and they all received "shave" excision of the tracheal cartilage. Among them, 12 patients had no postoperative residuum, 43 patients had microscopic residuum, and 13 patients had macroscopic residuum. All patients were divided into two groups according to treatment modality with or without EBRT; (1) the control group (n = 43) and (2) the EBRT group (n = 25).


RESULTS
The locoregional recurrence rate for EBRT patients was much lower than that of control patients (51% for the control group vs. 8% for the EBRT group) (p < 0.01). The 10-year local progression-free survival rate for the EBRT group was significantly better than that of the control group (89% in the EBRT group vs. 38% in the control group) (log-rank, p < 0.01). The use of adjuvant EBRT after conservative surgery was an independent prognostic factor in univariate and multivariate analyses.


CONCLUSIONS
External-beam radiotherapy was found to be effective, particularly in patients with thyroid cancer invading the trachea with microscopic or gross residuum after conservative surgery.
Department of Radiation Oncology, Yonsei Cancer Center, Brain Korea 21 Project for Medical Sciences, Yonsei University, College of Medicine, Seoul, Korea.
Ki Chang
KC
Keum
Yang Gun
YG
Suh
Woong Sub
WS
Koom
Jae Ho
JH
Cho
Su Jung
SJ
Shim
Chang Geol
CG
Lee
Chung Soo
CS
Park
Woong Youn
WY
Chung
Gwi Eon
GE
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D014134:Tracheal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
D007457:Iodine Radioisotopes