Intensity modulated radiotherapy in locally advanced thyroid cancer: Outcomes of a sequential phase I dose-escalation study.
Date
2018-04-01ICR Author
Author
Rooney, KP
Miah, AB
Bhide, SA
Guerrero-Urbano, MT
Sharabiani, MT
Newbold, KL
Grove, L
Harrington, KJ
Nutting, CM
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND AND PURPOSE: To determine the safety and tolerability of dose-escalation using modestly accelerated IMRT in high-risk locally advanced thyroid cancer requiring post-operative radiotherapy, and to report preliminary data on efficacy. MATERIALS AND METHODS: A sequential Phase I dose-escalation design was used. Dose level one (DL1) received 58.8 Gy/28F to the post-operative bed and 50 Gy/28F to elective nodes. DL2 received 66.6 Gy/30F to the thyroid bed, 60 Gy/30F to post-operative nodal levels and 54 Gy/30F to elective nodal levels. Acute (NCICTCv.2.0) and late toxicities (RTOG and modified LENTSOM) were recorded. The primary endpoint was the number of patients with ≥Grade 3 (G3) toxicity at 12 months post-treatment. RESULTS: Fifteen patients were recruited to DL1 and twenty-nine to DL2. At 12 months ≥G3 toxicities were 8.3% in both DL1 and DL2. At 60 months, ≥G3 toxicity was reported in 3 (33%) patients in DL1 and 1 (7%) in DL2. One patient in DL2 died at 24 months from radiation-induced toxicity. Time to relapse and overall survival rates were higher in DL2, but this was not statistically significant. Dose-escalation using this accelerated regimen can be safely performed with a toxicity profile similar to reported series using conventional doses.
Collections
Subject
Humans
Thyroid Neoplasms
Radiation Injuries
Neoplasm Staging
Treatment Outcome
Radiotherapy Dosage
Survival Rate
Cohort Studies
Dose-Response Relationship, Radiation
Middle Aged
Female
Male
Radiotherapy, Intensity-Modulated
Research team
Targeted Therapy
Language
eng
Date accepted
2018-02-01
License start date
2018-04
Citation
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2018, 127 (1), pp. 43 - 48
Publisher
ELSEVIER IRELAND LTD