Treatment of Unresectable Differentiated Thyroid Carcinoma With Upfront External Radiotherapy and Salvage Surgery: A STROBE-Compliant Retrospective Cohort Study.

Autor:	Carrillo JF; Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Flores JM; Departamento de Radioterapia, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Espinoza G; Subdirección de Cirugía, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Vázquez-Romo R; Subdirección de Cirugía, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Ramírez-Ortega MC; Direccion de Investigación, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Carrillo LC; Subdirección de Investigación Clínica, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Cortés-García BY; Departamento de Imagen, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Ochoa-Carrillo FJ; Subdirección de Cirugía, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Oñate-Ocaña LF; Subdirección de Investigación Clínica, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2021 Jan 19; Vol. 10, pp. 572958. Date of Electronic Publication: 2021 Jan 19 (Print Publication: 2020).
DOI:	10.3389/fonc.2020.572958
Abstrakt:	Introduction: In patients with unresectable Differentiated thyroid cancer (DTC), the use of external beam radiation therapy (EBRT), leads mostly to palliation. Our aim is to define the role of upfront EBRT, followed or not by salvage surgery, on Progression-free survival (PFS) or Overall survival (OS) in patients with DTC. Methods: This is a cohort study of patients with initially unresectable DTC who received EBRT. Cohort A received EBRT followed by rescue surgery and cohort B, EBRT only. The Kaplan-Meier method and Cox model were employed for survival analysis. Results: Thirty-three patients were included; 69.6% females and 30.3% males. Mean age was 60.6 and mean tumor diameter was 10.4 cm; 17 and 16 patients were included in cohorts A and B, respectively. Belonging to cohort A (Hazard ratio [HR] 0.177, 95% CI 0.05-0.7) and use of intensity modulated radiotherapy (HR 0.177, 95% CI 0.03-1.08) were associated to better PFS, while high-risk histopathology (HR 6.6, 95% CI 0.9-50) and EBRT dose (HR 1.05, 95% CI 1.01-1.08) were independently associated with lower PFS. Patients from cohort A (HR 0.061, 95% CI 0.01-0.3) had improved OS, while high-risk histopathology (HR 5.7, 95% CI 1.1-28.6) and EBRT dose (HR 1.05, 95% CI 1.01-1.09) were independently associated to worse OS. Conclusion: EBRT, and when feasible, salvage surgery, should be an integral part of the therapeutic strategy in initially unresectable DTC. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Carrillo, Flores, Espinoza, Vázquez-Romo, Ramírez-Ortega, Carrillo, Cortés-García, Ochoa-Carrillo and Oñate-Ocaña.)
Databáze:	MEDLINE
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