Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer
Purpose The treatment of recurrent thyroid cancer with critical organ invasion is challenging. The combination of radiofrequency ablation (RFA) and external beam radiation therapy (EBRT) has been proposed as an effective option. This study evaluates outcomes for inoperable residual/recurrent differe...
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Taylor & Francis Group
2024-12-01
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| Series: | International Journal of Hyperthermia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02656736.2024.2358054 |
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| author | Chung-Shih Chen Sheng-Dean Luo Yen-Hsiang Chang Chen Kai Chou Shun-Yu Chi Shao-Chun Wu Yen-Hao Chen Johnson Chia-Shen Yang Eng-Yen Huang Yu-Ming Wang Wei-Che Lin |
| author_facet | Chung-Shih Chen Sheng-Dean Luo Yen-Hsiang Chang Chen Kai Chou Shun-Yu Chi Shao-Chun Wu Yen-Hao Chen Johnson Chia-Shen Yang Eng-Yen Huang Yu-Ming Wang Wei-Che Lin |
| author_sort | Chung-Shih Chen |
| collection | DOAJ |
| description | Purpose The treatment of recurrent thyroid cancer with critical organ invasion is challenging. The combination of radiofrequency ablation (RFA) and external beam radiation therapy (EBRT) has been proposed as an effective option. This study evaluates outcomes for inoperable residual/recurrent differentiated thyroid cancer (rDTC) patients treated with RFA followed by EBRT.Materials and Methods Patients with rDTC treated with RFA followed by EBRT were retrospectively studied. RFA was performed using a free‐hand, ‘moving‐shot’ technique under US or CT guidance. For lesions invading critical structures intolerant to ‘en bloc’ high-temperature RFA, limited-field EBRT using 6‐ or 10‐MV photons was used for adjuvant treatment at a dose of 66 Gy in 33 daily fractions. Toxicities and outcomes were reviewed.Results Between April 2020 and January 2022, 11 patients with 14 rDTC lesions underwent RFA followed by EBRT. Five patients had metastatic lesions at rDTC diagnosis. With a median follow-up period of 33.7 months, all patients maintained locoregional control, while achieving a 2-year survival rate of 90.9%. This combined treatment achieved a volume reduction ratio of 92.1% ± 5.1%. The mean nadir thyroglobulin level in patients without initial distant metastases after treatment was 1.40 ± 0.81 ng/ml. Regarding treatment-related complications, one patient (9%) experienced temporary hoarseness after RFA, grade 2 radiation dermatitis occurred in 3 patients (27.2%), and grade 2 dysphagia was noted in 4 patients (36.4%). No grade 3 or greater toxicities occurred.Conclusions Salvage RFA followed by EBRT is feasible, effective and safe for patients with rDTC. |
| format | Article |
| id | doaj-art-54e4098e9a6644d9b871a03e2a08e16b |
| institution | Kabale University |
| issn | 0265-6736 1464-5157 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj-art-54e4098e9a6644d9b871a03e2a08e16b2025-01-03T09:30:27ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572024-12-0141110.1080/02656736.2024.2358054Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancerChung-Shih Chen0Sheng-Dean Luo1Yen-Hsiang Chang2Chen Kai Chou3Shun-Yu Chi4Shao-Chun Wu5Yen-Hao Chen6Johnson Chia-Shen Yang7Eng-Yen Huang8Yu-Ming Wang9Wei-Che Lin10Department of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Hemotology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanSchool of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, TaiwanPurpose The treatment of recurrent thyroid cancer with critical organ invasion is challenging. The combination of radiofrequency ablation (RFA) and external beam radiation therapy (EBRT) has been proposed as an effective option. This study evaluates outcomes for inoperable residual/recurrent differentiated thyroid cancer (rDTC) patients treated with RFA followed by EBRT.Materials and Methods Patients with rDTC treated with RFA followed by EBRT were retrospectively studied. RFA was performed using a free‐hand, ‘moving‐shot’ technique under US or CT guidance. For lesions invading critical structures intolerant to ‘en bloc’ high-temperature RFA, limited-field EBRT using 6‐ or 10‐MV photons was used for adjuvant treatment at a dose of 66 Gy in 33 daily fractions. Toxicities and outcomes were reviewed.Results Between April 2020 and January 2022, 11 patients with 14 rDTC lesions underwent RFA followed by EBRT. Five patients had metastatic lesions at rDTC diagnosis. With a median follow-up period of 33.7 months, all patients maintained locoregional control, while achieving a 2-year survival rate of 90.9%. This combined treatment achieved a volume reduction ratio of 92.1% ± 5.1%. The mean nadir thyroglobulin level in patients without initial distant metastases after treatment was 1.40 ± 0.81 ng/ml. Regarding treatment-related complications, one patient (9%) experienced temporary hoarseness after RFA, grade 2 radiation dermatitis occurred in 3 patients (27.2%), and grade 2 dysphagia was noted in 4 patients (36.4%). No grade 3 or greater toxicities occurred.Conclusions Salvage RFA followed by EBRT is feasible, effective and safe for patients with rDTC.https://www.tandfonline.com/doi/10.1080/02656736.2024.2358054Differentiated thyroid cancerradiofrequency ablationradiotherapycombination therapyinoperablerecurrence |
| spellingShingle | Chung-Shih Chen Sheng-Dean Luo Yen-Hsiang Chang Chen Kai Chou Shun-Yu Chi Shao-Chun Wu Yen-Hao Chen Johnson Chia-Shen Yang Eng-Yen Huang Yu-Ming Wang Wei-Che Lin Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer International Journal of Hyperthermia Differentiated thyroid cancer radiofrequency ablation radiotherapy combination therapy inoperable recurrence |
| title | Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer |
| title_full | Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer |
| title_fullStr | Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer |
| title_full_unstemmed | Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer |
| title_short | Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer |
| title_sort | salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer |
| topic | Differentiated thyroid cancer radiofrequency ablation radiotherapy combination therapy inoperable recurrence |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2024.2358054 |
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