External beam radiotherapy

Abstract

While surgery, radioiodine therapy (RIT) and TSH suppression therapy are generally accepted mainstays of therapy for differentiated thyroid carcinoma (DTC) [52, 67, 76], the role of external beam radiotherapy (RTx) remains controversial. Unequivocal indications for RTx of thyroid neoplasms are undifferentiated/ anaplastic thyroid carcinoma, thyroid lymphoma, locoregional recurrences and (pre-)symptomatic metastases when radical surgery is not possible and the tumour tissue or tumour residues after surgery have no sufficient I-131 uptake [64, 67, 75]. The case for adjuvant RTx in addition to surgery, RIT and TSH-suppressive therapy is however open to debate. With the exception of two prospective but inconclusive studies [6, 90], evidence is available only from retrospective surveys, with sometimes poorly defined inclusion criteria, inconsistent treatment regimens (different surgical procedures with or without ablative 131I therapy), or inconsistent or obsolete standards of radiotherapy. In the following we present a systematic review of the available evidence on adjuvant RTx for DTC. We do not discuss RTx for medullary carcinoma, which has been reviewed elsewhere [60]. © Springer-Verlag Berlin Heidelberg 2001, 2005.