Adjuvant External Beam Radiotherapy Reduces Local Recurrence in Poorly Differentiated Thyroid Cancer

作者：Pascal Jonker, Jan H. Koetje, John Turchini, Alex Lin, Anthony J. Gill, Thomas Eade, Ahmad Aniss, Roderick Clifton‐Bligh, Bettien M. van Hemel, Diana Learoyd, Hans H G Verbeek, Thera P. Links, Bruce Robinson, Venessa Tsang, Stanley Sidhu, Schelto Kruijff, Mark Sywak · 发表于：Annals of Surgical Oncology · 年份：2025 · DOI：10.1245/s10434-025-17434-2 · 被引用次数：3 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Head and Neck Anomalies

Abstract Background Poorly differentiated thyroid carcinoma (PDTC) accounts for 5% of all thyroid cancers and is responsible for a large proportion of thyroid cancer-related deaths. The optimal treatment approach is not clear. This study aimed to evaluate the effect of postoperative intensity-modulated radiotherapy (IMRT) on the treatment of resectable PDTC. Additionally, treatment-related morbidity, characteristics of 131 I-refractory disease, and factors affecting survival were assessed. Methods The study included consecutive PDTC cases from 1997 to 2018, defined according to Turin criteria and treated in two tertiary referral centers. Surgery, IMRT, 131 I, and systemic therapies were administered based on multidisciplinary team recommendations. The primary study outcome was 5-year local control after IMRT in cases with positive resection margins (micro- and macroscopic). The secondary outcomes were treatment-related morbidity within 30-days after completion of treatment (Clavien-Dindo and Common Terminology Criteria for Adverse Events [CTC-AE] 5.0), 131 I-refractory disease characteristics using standardized definitions, and factors influencing survival. Results Among 51 PDTC cases, 53% presented with metastatic disease. Adjuvant IMRT improved 5-year local control (100% vs. 17.5%; p = 0.02), with a higher number of grades 1 to 3 complications ( p = 0.005) versus cases without IMRT. Within 13 months, 131 I-refractory disease occurred in 62.7% of the patients and was more co...