TY - JOUR
T1 - 18
F-FDG Pet-Guided External Beam Radiotherapy in Iodine-Refractory Differentiated Thyroid Cancer: A Pilot Study
AU - Farina, Eleonora
AU - Monari, Fabio
AU - Castellucci, Paolo
AU - Romani, Fabrizio
AU - Repaci, Andrea
AU - Farina, Arianna
AU - Rambaldi, Giuseppe Zanirato
AU - Frezza, Giovanni
AU - Mazzarotto, Renzo
AU - Cammelli, Silvia
AU - Tagliaferri, Luca
AU - Autorino, Rosa
AU - Deodato, Francesco
AU - Macchia, Gabriella
AU - Cilla, Savino
AU - Valentini, Vincenzo
AU - Fanti, Stefano
AU - Morganti, Alessio G.
AU - Morganti, Alessio Giuseppe
PY - 2017
Y1 - 2017
N2 - Introduction:
To evaluate the clinical response rate after a postoperative 18F-FDG PET/CT guided external beam radiotherapy (EBRT) in Iodine-refractory differentiated thyroid cancer.
Material and Methods:
Patients with thyroid cancer locally recurrent after total thyroidectomy plus metabolic radiotherapy and treated with radical EBRT were included. Inclusion criteria were detectable thyroglobulin (Tg), negative postmetabolic radiotherapy whole body scintigraphy, and no surgical indications. The pretreatment 18F-FDG PET/CT resulted positive in all cases (loggia, lymph nodes, and lung). EBRT was delivered with IMRT-SIB technique. A 18F-FDG PET/CT revaluation and Tg dosage were performed 3 months after the treatment.
Results:
Sixteen consecutive patients were included in this analysis (median follow-up: 6-44 months). Post-EBRT 18F-FDG PET/CT showed CR in 43.7%, PR in 31.2%, SD in 25.0% patients, and PD due to lung metastases in 12.5%. Overall response rate was 75.0% (CI 95%: 41.4-93.3%). Tg levels decreased in 75.0% with a median Δ of 68.0%. Two-year PFS and OS rates were 80.0% and 93.0%, respectively. Acute G3 toxicity occurred in 18.7% and late G2 toxicity in 12.5%.
Conclusions:
18F-FDG PET/CT was useful in target definition for radiotherapy planning, identifying positive areas not detected with 131I scintigraphy. IMRT based EBRT was feasible and our results encourage future prospective studies. This clinical trial is registered with ID: NCT03191643.
AB - Introduction:
To evaluate the clinical response rate after a postoperative 18F-FDG PET/CT guided external beam radiotherapy (EBRT) in Iodine-refractory differentiated thyroid cancer.
Material and Methods:
Patients with thyroid cancer locally recurrent after total thyroidectomy plus metabolic radiotherapy and treated with radical EBRT were included. Inclusion criteria were detectable thyroglobulin (Tg), negative postmetabolic radiotherapy whole body scintigraphy, and no surgical indications. The pretreatment 18F-FDG PET/CT resulted positive in all cases (loggia, lymph nodes, and lung). EBRT was delivered with IMRT-SIB technique. A 18F-FDG PET/CT revaluation and Tg dosage were performed 3 months after the treatment.
Results:
Sixteen consecutive patients were included in this analysis (median follow-up: 6-44 months). Post-EBRT 18F-FDG PET/CT showed CR in 43.7%, PR in 31.2%, SD in 25.0% patients, and PD due to lung metastases in 12.5%. Overall response rate was 75.0% (CI 95%: 41.4-93.3%). Tg levels decreased in 75.0% with a median Δ of 68.0%. Two-year PFS and OS rates were 80.0% and 93.0%, respectively. Acute G3 toxicity occurred in 18.7% and late G2 toxicity in 12.5%.
Conclusions:
18F-FDG PET/CT was useful in target definition for radiotherapy planning, identifying positive areas not detected with 131I scintigraphy. IMRT based EBRT was feasible and our results encourage future prospective studies. This clinical trial is registered with ID: NCT03191643.
KW - 18F-FDG PET/CT, thyroid cancer, EBRT
KW - 18F-FDG PET/CT, thyroid cancer, EBRT
UR - http://hdl.handle.net/10807/111794
U2 - 10.1155/2017/9807543
DO - 10.1155/2017/9807543
M3 - Article
SN - 2090-8067
VL - 2017
SP - 9807543
EP - 9807543
JO - Journal of Thyroid Research
JF - Journal of Thyroid Research
ER -
