The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
The value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differ...
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Bioscientifica
2019-12-01
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Series: | Endocrine Connections |
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Online Access: | https://doi.org/10.1530/EC-19-0387 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Aleksandra Kukulska Jolanta Krajewska Zofia Kolosza Ewa Paliczka-Cieslik Aleksandra Kropinska Agnieszka Pawlaczek Zbigniew Puch Kornelia Ficek Teresa Lisik Dorota Sygula Zbigniew Wygoda Jozef Roskosz Jerzy Wydmanski Barbara Jarzab |
spellingShingle |
Aleksandra Kukulska Jolanta Krajewska Zofia Kolosza Ewa Paliczka-Cieslik Aleksandra Kropinska Agnieszka Pawlaczek Zbigniew Puch Kornelia Ficek Teresa Lisik Dorota Sygula Zbigniew Wygoda Jozef Roskosz Jerzy Wydmanski Barbara Jarzab The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma Endocrine Connections medullary thyroid carcinoma adjuvant radiotherapy postoperative radiotherapy radiation treatment |
author_facet |
Aleksandra Kukulska Jolanta Krajewska Zofia Kolosza Ewa Paliczka-Cieslik Aleksandra Kropinska Agnieszka Pawlaczek Zbigniew Puch Kornelia Ficek Teresa Lisik Dorota Sygula Zbigniew Wygoda Jozef Roskosz Jerzy Wydmanski Barbara Jarzab |
author_sort |
Aleksandra Kukulska |
title |
The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma |
title_short |
The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma |
title_full |
The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma |
title_fullStr |
The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma |
title_full_unstemmed |
The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma |
title_sort |
role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma |
publisher |
Bioscientifica |
series |
Endocrine Connections |
issn |
2049-3614 2049-3614 |
publishDate |
2019-12-01 |
description |
The value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differences in respo nse to radiotherapy between hereditary and sporadic MTC.
Methods: A retrospective analysis involved 254 MTC patients, among them 73 patients with a hereditary disease. Two hundred and twenty-four patients, including 43 persons at a high risk of local relapse, underwent only initial surgery; 18 other patients were operated due to MTC recurrences, whereas the remaining 12 patients had cytoreductive procedure or were not amenable for surgery. Radiotherapy was carried out in 132 patients. One hundred and twenty patients underwent adjuvant radiotherapy, among them 102 patients after initial surgery. The median follow-up was 10 years (range 0.5–29 years).
Results: Local recurrence occurred in 107/254 patients, among them in 63 subjects after prior radiotherapy. The frequency of relapse showed significantl y increasing trend toward higher MTC stages (P <0.001). More relapses occurred in patients with lymph node metastases present at MTC onset. Adjuvant radiotherapy was associated with a lower risk of nodal recurrence only in high-risk patients, particularly if lymph node metastases were present at MTC diagnosis. The differences betwee n hereditary and sporadic subgroups were not significant.
Conclusions: Adjuvant radiotherapy has a limited importance in MTC treatment. It should be considered in high-risk MTC patients. The presence of RET mu tation does not influence the response to radiation.
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topic |
medullary thyroid carcinoma adjuvant radiotherapy postoperative radiotherapy radiation treatment |
url |
https://doi.org/10.1530/EC-19-0387 |
work_keys_str_mv |
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doaj-3e5b1885cdcb4b15aa1de69bb0acc33d2020-11-25T02:08:01ZengBioscientificaEndocrine Connections2049-36142049-36142019-12-019118https://doi.org/10.1530/EC-19-0387The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinomaAleksandra Kukulska0Jolanta Krajewska1Zofia Kolosza2Ewa Paliczka-Cieslik3Aleksandra Kropinska4Agnieszka Pawlaczek5Zbigniew Puch6Kornelia Ficek7Teresa Lisik8Dorota Sygula9Zbigniew Wygoda10Jozef Roskosz11Jerzy Wydmanski12Barbara Jarzab13Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland; Radiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandDepartment of Epidemiology and Silesia Cancer Registry, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandRadiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandRadiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandRadiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandRadiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandNuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, PolandThe value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differences in respo nse to radiotherapy between hereditary and sporadic MTC. Methods: A retrospective analysis involved 254 MTC patients, among them 73 patients with a hereditary disease. Two hundred and twenty-four patients, including 43 persons at a high risk of local relapse, underwent only initial surgery; 18 other patients were operated due to MTC recurrences, whereas the remaining 12 patients had cytoreductive procedure or were not amenable for surgery. Radiotherapy was carried out in 132 patients. One hundred and twenty patients underwent adjuvant radiotherapy, among them 102 patients after initial surgery. The median follow-up was 10 years (range 0.5–29 years). Results: Local recurrence occurred in 107/254 patients, among them in 63 subjects after prior radiotherapy. The frequency of relapse showed significantl y increasing trend toward higher MTC stages (P <0.001). More relapses occurred in patients with lymph node metastases present at MTC onset. Adjuvant radiotherapy was associated with a lower risk of nodal recurrence only in high-risk patients, particularly if lymph node metastases were present at MTC diagnosis. The differences betwee n hereditary and sporadic subgroups were not significant. Conclusions: Adjuvant radiotherapy has a limited importance in MTC treatment. It should be considered in high-risk MTC patients. The presence of RET mu tation does not influence the response to radiation. https://doi.org/10.1530/EC-19-0387medullary thyroid carcinomaadjuvant radiotherapypostoperative radiotherapyradiation treatment |