Citation Information :
Higashiyama S, Yoshida A, Katayama Y, Yamanaga T, Kawabe J. Usefulness of CyberKnife Therapy in Patients with Differentiated Thyroid Cancer with Distant Metastases. Int J Otorhinolaryngol Clin 2020; 12 (2):38-41.
Aim and objective: We reported seven cases in which external beam radiotherapy (EBRT) with CyberKnife therapy was effective against distant metastases from differentiated thyroid carcinoma (DTC).
Materials and methods: The subjects included seven patients (6 males, 1 female; age 53–77 years, average age 65.85 years) who underwent CyberKnife therapy for metastatic lesions of DTC (pathological diagnosis: differentiated papillary carcinoma). The target lesions included 12 lymph node, 6 bone, and 2 brain metastases. All patients had previously undergone total thyroidectomy, followed by radioactive iodine therapy (RAIT). Since RAIT was not expected to have a therapeutic effect, CyberKnife treatment was selected. CyberKnife irradiation was performed 1–5 times. The radiation doses covering 95% of the planning target volume (D95) ranged from 15 to 26 gray (Gy). To determine the therapeutic effect, lesion size was evaluated by computed tomography (CT) and magnetic resonance imaging (MRI) before and 6–12 months after treatment.
Results: No increase in size was observed in the brain and bone metastases. Among the lymph node metastatic lesions, a therapeutic effect involving internal necrosis without an increase in size was noted in two lymph node metastases in the cervix. Additionally, two lymph node metastases in the neck had reduced in size. No increases in size were observed in the other lymph node lesions, reflecting the therapeutic effect of CyberKnife.
Conclusions: CyberKnife may be useful in treating distant metastatic lesions of papillary thyroid cancer.
Clinical significance: CyberKnife is useful as a multidisciplinary treatment for cases in which radioactive iodine therapy is maladjusted.
Kenji M, Yasushi H, Shintaro T, et al. Treatment intensity and control rates in combining external-beam radiotherapy and radioactive iodine therapy for metastatic or recurrent differentiated thyroid cancer. Int J Clin Oncol 2020;25(4):691–697. DOI: 10.1007/s10147-019-01591-y.
Bacourt F, Asselain B, Savoie JC, et al. Multifactorial study of prognostic factors in differentiated thyroid carcinoma and a re-evaluation of the importance of age. Br J Surg 1986;73(4):274–277. DOI: 10.1002/bjs.1800730410.
Kim TH, Yang DS, Jung KY, et al. Value of external irradiation for locally advanced papillary thyroid cancer. Int J Radiat Oncol Biol Phys 2003;55(4):1006–1012. DOI: 10.1016/s0360-3016(02)04203-7.
Brierley JD, Tsang RW. External-beam radiation therapy in the treatment of differentiated thyroid cancer. Semin Surg Oncol 1999;16(1):42–49. DOI: 10.1002/(sici)1098-2388(199901/02)16:1<42::aid-ssu8>3.0.co;2-4.
Kiess AP, Agrawal N, Brierley JD, et al. External-beam radiotherapy for differentiated thyroid cancer locoregional control: a statement of the American Head and Neck Society. Head Neck 2016;38(4):493–498. DOI: 10.1002/hed.24357.
Ford D, Giridharan S, McConkey C, et al. External beam radiotherapy in the management of differentiated thyroid cancer. Clin Oncol 2003;15(6):337–341. DOI: 10.1016/s0936-6555(03)00162-6.
Naohiro K, Hideya Y, Takuji T, et al. Stereotactic body radiation therapy for head and neck tumor: disease control and morbidity outcomes. J Radiat Res 2011;52(1):24–31. DOI: 10.1269/jrr.10086.
Joji K, Shigeaki H, Mitsuharu S, et al. Usefulness of stereotactic radiotherapy using cyberknife for recurrent lymph node metastasis of differentiated thyroid cancer. Case Rep Endocrinol 2017;2017:7956726. DOI: 10.1155/2017/7956726.
Hideya Y, Mikio O, Naohiro K, et al. Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: a multi-institutional study. Radiother Oncol 2013;107(3)305–309. DOI: 10.1016/j.radonc.2013.05.005.
Hideya Y, Mikio O, Kengo H, et al. Carotid blowout syndrome in pharyngeal cancer patients treated by hypofractionated stereotactic re-irradiation using CyberKnife: a multi-institutional matched-cohort analysis. Radiother Oncol 2015;115(1):67–71. DOI: 10.1016/j.radonc.2015.02.021.
Terezakis SA, Lee KS, Ghossein RA, et al. Role of external beam radiotherapy in patients with advanced or recurrent nonanaplastic thyroid cancer: memorial Sloan-kettering cancer center experience. Int J Radiat Oncol Biol Phys 2009;73(3):795–801. DOI: 10.1016/j.ijrobp.2008.05.012.
Meadows KM, Amdur RJ, Morris CG, et al. External beam radiotherapy for differentiated thyroid cancer. Am J Otolaryngol 2006;27(1):24–28. DOI: 10.1016/j.amjoto.2005.05.017.
Takayuki I, Takashi U, Kiminori S, et al. Stereotactic radiotherapy using the CyberKnife is effective for local control of bone metastases from differentiated thyroid cancer. J Radiat Res 2019;22;60(6):831–836. DOI: 10.1093/jrr/rrz056.
Takayuki I, Takashi U, Tomoaki T, et al. Usefulness of stereotactic radiotherapy using the CyberKnife for patients with inoperable locoregional recurrences of differentiated thyroid cancer. World J Surg 2019;43(2):513–518. DOI: 10.1007/s00268-018-4813-5.
Martin SG, Makoto T, Lori JW, et al. Lenvatinib versus placebo in radioiodine-refractory thyroid cancer. N Engl J Med 2015;372:621–630. DOI: 10.1056/NEJMoa1406470.
Hiroshi T, Koichi I, Kiminori S. Development of molecular targeted drugs for advanced thyroid cancer in Japan. Endocrine J 2014;61(9):833–839. DOI: 10.1507/endocrj.ej14-0107.
Ye X, Zhu Y, Cai J. Relationship between toxicities and clinical benefits of newly approved tyrosine kinase inhibitors in thyroid cancer: a meta-analysis of literature. J Cancer Res Ther 2015;11(2):C185–C190. DOI: 10.4103/0973-1482.168182.
Nigel F, Rachel H, Marty C, et al. A systematic review of lenvatinib and sorafenib for treating progressive, locally advanced or metastatic, differentiated thyroid cancer after treatment with radioactive iodine. BMC Cancer 2019 Dec 12:19(1):1209. DOI: 10.1186/s12885-019-6369-7.
Anderson RT, Linnehan JE, Tongbram V, et al. Clinical, safety, and economic evidence in radioactive iodine-refractory differentiated thyroid cancer: a systematic literature review. Thyroid. 2013;23(4):392–407. DOI: 10.1089/thy.2012.0520.
Chen L, Shen Y, Luo Q, et al. Response to sorafenib at a low dose in patients with radioiodine-refractory pulmonary metastases from papillary thyroid carcinoma. Thyroid 2011;21(2):119–124. DOI: 10.1089/thy.2010.0199.
Lee EM, Lee JW, Lee JY, et al. Lower starting dose of sorafenib for thyroid cancer: a case report and literature review. J Thyroid Disord Ther 2015;4:4. DOI: 10.4172/2167-7948.1000196.