Dandekar, P., Harmer, C., Barbachano, Y., Rhys-Evans, P., Harrington, K., Nutting, C., Newbold, K. (2009) HYPERFRACTIONATED ACCELERATED RADIOTHERAPY (HART) FOR ANAPLASTIC THYROID CARCINOMA: TOXICITY AND SURVIVAL ANALYSIS. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 74 (2). pp. 518-521. ISSN 0360-3016

Full text not available from this repository.

Abstract

Purpose: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive cancers, and the current protocol of hyperfractionated accelerated radiotherapy was initiated to improve survival while limiting toxicities. Methods and Materials: All patients with ATC from 1991 to 2002 were accrued and received megavoltage radiotherapy from-the mastoid processes to the carina up to 60 Gy in twice-daily fractions of 1.8 and 2 Gy, 6 hours apart. Results: Thirty-one patients were accrued with a median age of 69 years, and 55% were women. Debulking was performed in 26%, and total thyroidectomy, in 6%, whereas 68% received radical radiotherapy alone. Local control data were available for 27 patients: 22% had a complete response, 26% had a partial response, 15% showed progressive disease, and 37% showed static disease. Median overall survival for all 31 patients was 70 days (95% confidence interval, 40-99). There was no significant difference in median survival between patients younger (70 days) and older than 70 years (42 days), between men (70 days) and women (49 days), and between patients receiving postoperative radiotherapy (77 days) and radical radiotherapy alone (35 days). Grade III or higher skin erytherma was seen in 56% patients; desquamation in 21%; dysphagia in 74%; and esophagitis in 79%. Conclusion: The current protocol failed to offer a significant survival benefit, was associated with severe toxicities, and thus was discontinued. There is a suggestion that younger patients with operable disease have longer survival, but this would require a larger study to confirm it. (C) 2009 Elsevier Inc.

Item Type:	Article
Authors (ICR Faculty only):	Harrington, Kevin and Nutting, Chris
All Authors:	Dandekar, P., Harmer, C., Barbachano, Y., Rhys-Evans, P., Harrington, K., Nutting, C., Newbold, K.
Uncontrolled Keywords:	Anaplastic thyroid cancer; Hyperfractionated radiotherapy; Accelerated radiotherapy; Radiation toxicity; Altered fractionation GIANT-CELL CARCINOMA; PROGNOSTIC-FACTORS; CHEMOTHERAPY; SURGERY; ESTABLISHMENT; CANCER
Research teams:	Clinical Units > Thyroid Unit Clinical Units > Head & Neck Cancer Unit ICR divisions > Cancer Biology > Targeted Therapy ICR divisions > Radiotherapy and Imaging > Targeted Therapy
Depositing User:	Users 10 not found.
Date Deposited:	01 Jun 2009 08:00
Last Modified:	10 Feb 2010 11:51
URI:	http://publications.icr.ac.uk/id/eprint/8100

Actions (login required)

View Item