Study of External Beam Radiotherapy to Thyroid Carcinoma
Thyroid Cancer
About this trial
This is an interventional treatment trial for Thyroid Cancer focused on measuring Thyroid Carcinoma, External Beam Radiotherapy
Eligibility Criteria
Inclusion Criteria:
- Pathologically confirmed differentiated thyroid cancer
- Patient with locally advanced tumor (T4a, tumor of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve or T4b, tumor invades prevertebral fascia or encases carotid artery or mediastinal vessels or N1b, unilateral, bilateral, or contralateral cervical or mediastinal lymph node positive), or locoregionally recurrent tumor
- All patients must have radiographically assessable disease
- No previous irradiation to the planned field
- Age of ≥ 18 years
- Performance status of 0 to 2 on the Eastern Cooperative Oncology Group (ECOG) score
- Required Entry Laboratory Parameters WBC count ≥ 1,000/mm3; hemoglobin level ≥ 7.5 g/dL; platelet count ≥ 100,000/mm3; creatinine ≤ 3.0 mg/dL
- Oral intake (including J-tube feeding) of ≥ 1,500 calories/day should be maintained.
- Signed informed consent form prior to study entry
Exclusion Criteria:
- Patient with anaplastic carcinoma (focal anaplastic change associate with differentiated thyroid cancer is not excluded)
- Age of <18 years
- Previous history of RT adjacent to planned field
- Poor performance status of 3 to 4 on the Eastern Cooperative Oncology Group (ECOG) score
- Pregnant or breast feeding status
- Previous history of uncontrolled other malignancies within 2 years
Sites / Locations
- National Cancer Center, Korea
Arms of the Study
Arm 1
Experimental
External Beam Radiotherapy
Definition of target volume: Gross tumor volume (GTV) = gross tumor defined with intravenous bolus contrast administration given CT scan Clinical target volume (CTV) = GTV + included volumes of clinical and suspected subclinical involvement (draining lymph nodes) Planning target volume (PTV) = CTV + 5-10 mm of lateral, craniocaudal, and anteroposterior margins. Radiation dose and planning : Total dose 65 Gy for gross tumor, 62.4 Gy for microscopic involved area, 58.5 Gy for high risk lymph node area and 52 Gy for elective lymph node area in 26 fractions during 6 weeks Dose prescription: 90% isodose volume of prescribed dose encompassed PTV The dose-volume histogram (DVH) of targets, such as GTV, CTV, and PTV, and the normal tissues, such as the esophagus, lung, contralateral normal thyroid, arytenoids, vocal cord and spinal cord, etc., was calculated.