Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_36_2853 - Hypofractionated Radiation Therapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Hypofractionated Radiation Therapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution
N. Takahashi1, H. Matsushita1, R. Umezawa1, T. Yamamoto1, Y. Ishikawa1, Y. Katagiri1, S. Tasaka1, K. Takeda1, K. Fukui2, N. Kadoya1, K. Ito1, and K. Jingu1; 1Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan, 2Tohoku University Graduate School of Medicine, Sendai, Japan

Purpose/Objective(s): Anaplastic thyroid carcinoma is a rare cancer and has a poor prognosis. Several radiation protocols have been reported, but the results were not satisfactory. The aim of this study was to determine the effect of hypofractionated radiotherapy.

Materials/Methods: Thirty-three patients (21 male patients and 12 female patients) who received radiotherapy for ATC between 2000 and 2014 in our institution were included in this study.

Results: Nineteen patients were treated with ≥ 5 Gy per fraction (Gy/fr), and 18 of those patients received 5 Gy/fr. Twenty-eight patients died, and 27 of those patients died from ATC. Sixteen patients died from distance metastasis and 6 patients died from local recurrence. In the ≥ 5 Gy/fr group, local recurrence occurred in 5 patients and 1 of them died from active bleeding from a local tumor. There was local recurrence in 7 patients who received the other protocol, and 5 of them died from asphyxiation, active bleeding or uncontrollable growth of a local tumor on the neck. The median overall survival (OS) period in all patients was 5 months. In multivariate analysis, patients who received an equivalent dose in 2 Gy fractions (EQD2) ≥ 50 Gy had significantly better OS (p = 0.016). In univariate analysis, patients who received ≥ 5 Gy/fr did not have significantly better OS (p = 0.872) or LC (p = 0.090). The chi-squared test showed that significantly fewer patients died from local recurrence in the ≥ 5 Gy/fr group (p = 0.025).

Conclusion: Multivariate analysis showed that EQD2 ≥ 50 Gy resulted in better OS, and ≥ 5 Gy/fr decreased the rate of mortality from local recurrence.
Multivariate analysis for OS.
HR 95 % CI p value
Male vs female 2.14 0.96-5.13 0.064
EQD2 (≥ 50 Gy vs < 50 Gy) 0.26 0.097-0.76 0.016
Note: OS = overall survival, HR = Hazard ratio, CI = confidence interval, EQD2 = equivalent dose in 2 Gy fractions. Factors with p < 0.01 in univariate analysis were included in multivariate analysis.

Author Disclosure: N. Takahashi: None. H. Matsushita: None. R. Umezawa: None. T. Yamamoto: None. S. Tasaka: None. K. Fukui: None. K. Ito: None.

Noriyoshi Takahashi, MD, PhD

Biography:
Noriyoshi Takahashi, M.D., Ph.D. has been Assistant Professor in the Department of Radiation Oncology Tohoku University Hospital since 2016.
He received his M.D. in 2011 from Tohoku University School of Medicine, Japan, and he received his Ph.D. in 2016 from Tohoku University Graduate School of Medicine, Japan.
His research interests lie in the area of radiotherapy of esophageal cancer and head and neck cancer and in the area of prognostic research using functional imaging. He received a scientific award of the 27th annual meeting of JASTRO in 2014.

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