RT Dose Associated With Improved Anaplastic Thyroid Cancer Survival

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Patients with unresected anaplastic thyroid carcinoma who receive greater than 60 Gy of radiation appear to have a longer median overall survival.
Patients with unresected anaplastic thyroid carcinoma who receive greater than 60 Gy of radiation appear to have a longer median overall survival.

Patients with unresected anaplastic thyroid carcinoma who receive greater than 60 Gy of radiation appear to have a longer median overall survival than those given 45 to 59.9 Gy, according to a study published in Cancer.1

Anaplastic thyroid carcinoma is a rare but extremely aggressive malignancy of the head and neck that accounts for about 40% of all thyroid cancer-related deaths. Although there are no standard treatment regimens for this disease, most patients receive multimodality therapy with surgery, radiation, and chemotherapy.

To assess outcomes of patients with unresectable anaplastic thyroid carcinoma and explore potential correlations between radiation therapy dose and overall survival, investigators analyzed data from 1288 patients included in the National Cancer Data Base who underwent no surgery or incomplete resection. Of those, 47.6% received radiation therapy to the neck. Average age was 70.2 years.

The median overall survival was 2.27 months; 11% of patients were alive at 1 year. There was a positive correlation between radiation therapy dose and survival for the overall study population, for those who received systemic therapy, and for those with stage IVA/IVB and IVC disease.

Receipt of radiation doses between 45 and 59.9 Gy was associated with a 40% reduced risk of death compared with no radiation therapy (hazard ratio [HR], 0.596; 95% CI, 0.479-0.743), while receipt of doses between 60 and 75 Gy was associated with a 58% reduced risk of death vs no radiation (HR, 0.419; 95% CI, 0.339-0.517).

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Older age and having at least 1 comorbidity were associated with a 32% (HR, 1.317; 95% CI, 1.137-1.526) and 59% (HR, 1.587; 95% CI, 1.379-1.827) higher risk of mortality, respectively. Receipt of systemic therapy was associated with a 36% lower risk of death (HR, 0.637; 95% CI, 0.547-0.742).

Reference

  1. Pezzi TA, Mohamed ASR, Sheu T, et al. Radiation therapy dose is associated with improved survival for unresected anaplastic thyroid carcinoma: outcomes from the National Cancer Data Base. Cancer. 2016 Dec 27. doi: 10.1002/cncr.30493 [Epub ahead of print]

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