Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan
The role of adjuvant external-beam radiotherapy (EBRT) for locally advanced differentiated thyroid cancer (DTC) is controversial because of the lack of prospective data. To prepare for a clinical trial, this study investigated the current clinical practice of adjuvant treatments for locally advanced...
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The Japan Endocrine Society
2023-10-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/70/10/70_EJ23-0330/_html/-char/en |
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| author | Terufumi Kawamoto Koichi Yasuda Yoshinori Ito Sadamoto Zenda Katsuyuki Sakanaka Naoto Shikama Naoki Nakamura Takashi Mizowaki |
| author_facet | Terufumi Kawamoto Koichi Yasuda Yoshinori Ito Sadamoto Zenda Katsuyuki Sakanaka Naoto Shikama Naoki Nakamura Takashi Mizowaki |
| author_sort | Terufumi Kawamoto |
| collection | DOAJ |
| description | The role of adjuvant external-beam radiotherapy (EBRT) for locally advanced differentiated thyroid cancer (DTC) is controversial because of the lack of prospective data. To prepare for a clinical trial, this study investigated the current clinical practice of adjuvant treatments for locally advanced DTC. A survey on treatment selection criteria for hypothetical locally advanced DTC was administered to representative thyroid surgeons of facilities participating in the Japan Clinical Oncology Group Radiation Therapy Study Group. Of the 43 invited facilities, surgeons from 39 (91%) completed the survey. For R1 resection or suspected residual disease, 26 (67%) facilities administered high-dose (100–200 mCi) radioactive iodine (RAI), but none performed EBRT. For R2 resection or unresectable primary disease, 26 (67%) facilities administered high-dose RAI and 7 (18%) performed adjuvant treatments, including EBRT. For complete resection with nodal extra-capsular extension, 13 (34%) facilities administered high-dose RAI and 1 (3%) performed EBRT. For unresectable mediastinal lymph node metastasis, 31 (79%) facilities administered high-dose RAI and 5 (13%) performed adjuvant treatments, including EBRT. Adjuvant EBRT was not routinely performed mainly because of the lack of evidence for efficacy (74%). Approximately 15% of the facilities routinely considered adjuvant EBRT for DTC with R2 resection or unresectable primary or lymph node metastasis disease. Future clinical trials will need to optimize EBRT for these patients. |
| format | Article |
| id | doaj-art-4840a101bf084caf862d3eb1800b00a0 |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-4840a101bf084caf862d3eb1800b00a02025-01-22T06:19:20ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402023-10-017010999100310.1507/endocrj.EJ23-0330endocrjAdjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in JapanTerufumi Kawamoto0Koichi Yasuda1Yoshinori Ito2Sadamoto Zenda3Katsuyuki Sakanaka4Naoto Shikama5Naoki Nakamura6Takashi Mizowaki7Department of Radiation Oncology, Juntendo University, Graduate School of Medicine, Tokyo 113-8421, JapanDepartment of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido 060-8638, JapanDepartment of Radiation Oncology, Showa University School of Medicine, Tokyo 142-8555, JapanDepartment of Radiation Oncology, National Cancer Center Hospital East, Chiba 277-8577, JapanDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, JapanDepartment of Radiation Oncology, Juntendo University, Graduate School of Medicine, Tokyo 113-8421, JapanDepartment of Radiation Oncology, St.Marianna University School of Medicine Hospital, Kanagawa 216-8511, JapanDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, JapanThe role of adjuvant external-beam radiotherapy (EBRT) for locally advanced differentiated thyroid cancer (DTC) is controversial because of the lack of prospective data. To prepare for a clinical trial, this study investigated the current clinical practice of adjuvant treatments for locally advanced DTC. A survey on treatment selection criteria for hypothetical locally advanced DTC was administered to representative thyroid surgeons of facilities participating in the Japan Clinical Oncology Group Radiation Therapy Study Group. Of the 43 invited facilities, surgeons from 39 (91%) completed the survey. For R1 resection or suspected residual disease, 26 (67%) facilities administered high-dose (100–200 mCi) radioactive iodine (RAI), but none performed EBRT. For R2 resection or unresectable primary disease, 26 (67%) facilities administered high-dose RAI and 7 (18%) performed adjuvant treatments, including EBRT. For complete resection with nodal extra-capsular extension, 13 (34%) facilities administered high-dose RAI and 1 (3%) performed EBRT. For unresectable mediastinal lymph node metastasis, 31 (79%) facilities administered high-dose RAI and 5 (13%) performed adjuvant treatments, including EBRT. Adjuvant EBRT was not routinely performed mainly because of the lack of evidence for efficacy (74%). Approximately 15% of the facilities routinely considered adjuvant EBRT for DTC with R2 resection or unresectable primary or lymph node metastasis disease. Future clinical trials will need to optimize EBRT for these patients.https://www.jstage.jst.go.jp/article/endocrj/70/10/70_EJ23-0330/_html/-char/enadjuvant therapyexternal-beam radiotherapy (ebrt)radioactive iodine (rai)thyroid carcinoma |
| spellingShingle | Terufumi Kawamoto Koichi Yasuda Yoshinori Ito Sadamoto Zenda Katsuyuki Sakanaka Naoto Shikama Naoki Nakamura Takashi Mizowaki Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan Endocrine Journal adjuvant therapy external-beam radiotherapy (ebrt) radioactive iodine (rai) thyroid carcinoma |
| title | Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan |
| title_full | Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan |
| title_fullStr | Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan |
| title_full_unstemmed | Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan |
| title_short | Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan |
| title_sort | adjuvant treatments for locally advanced differentiated thyroid cancer a nationwide survey in japan |
| topic | adjuvant therapy external-beam radiotherapy (ebrt) radioactive iodine (rai) thyroid carcinoma |
| url | https://www.jstage.jst.go.jp/article/endocrj/70/10/70_EJ23-0330/_html/-char/en |
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