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Radiat Oncol J. 2017 Jun;35(2):112-120. English. Original Article. https://doi.org/10.3857/roj.2017.00192
Kim YS , Choi JH , Kim KS , Lim GC , Kim JH , Kang JW , Song HS , Lee SA , Hyun CL , Choi Y , Kim GE .
Department of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea. gekim@yuhs.ac
Department of Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
Department of Otorhinolaryngology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
Department of Nuclear Medicine and Molecular Imaging, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
Department of Pathology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Abstract

PURPOSE: To evaluate the effect of adjuvant external beam radiation therapy (EBRT) on local failure-free survival rate (LFFS) for papillary thyroid cancer (PTC) invading the trachea. MATERIALS AND METHODS: Fifty-six patients with locally advanced PTC invading the trachea were treated with surgical resection. After surgery, 21 patients received adjuvant EBRT and radioactive iodine therapy (EBRT group) and 35 patients were treated with radioactive iodine therapy (control group). RESULTS: The age range was 26–87 years (median, 56 years). The median follow-up period was 43 months (range, 4 to 145 months). EBRT doses ranged from 50.4 to 66 Gy (median, 60 Gy). Esophagus invasion and gross residual disease was more frequent in the EBRT group. In the control group, local recurrence developed in 9 (9/35, 26%) and new distant metastasis in 2 (2/35, 6%) patients, occurring 4 to 68 months (median, 37 months) and 53 to 68 months (median, 60 months) after surgery, respectively. Two patients had simultaneous local recurrence and new distant metastasis. There was one local failure in the EBRT group at 18 months after surgery (1/21, 5%). The 5-year LFFS was 95% in the EBRT group and 63% in the control group (p = 0.103). In the EBRT group, one late grade 2 xerostomia was developed. CONCLUSION: Although, EBRT group had a higher incidence of esophagus invasion and gross residual disease, EBRT group showed a better 5-year LFFS. Adjuvant EBRT may have contributed to the better LFFS in these patients.

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