scholarly journals Case Report: Management of an Elderly Patient With Metastatic Radioiodine-Resistant Differentiated Thyroid Cancer in a Rural Community, Remote From Specialist Oncology Services

2021 ◽  
Vol 11 ◽  
Author(s):  
Rachael Wybrew ◽  
Michael Loynd ◽  
Maria Wybrew ◽  
Leslie Samuel
Keyword(s):  
Elderly Patient ◽  
Thyroid Cancer ◽  
Case Report ◽  
Differentiated Thyroid Cancer ◽  
Local Community ◽  
External Beam Radiotherapy ◽  
Cauda Equina ◽  
Rural Setting ◽  
Cancer Center ◽  
External Beam

This case report describes an elderly patient with radioiodine-resistant differentiated thyroid cancer and additional multiple metastases living in a rural setting, remote from the specialist oncology service. This case is of interest because effective systemic therapies for treatment-resistant cancers, such as lenvatinib, are now available but can potentially cause significant toxicities that require extensive medical management. Here, we discuss how patient care was provided collaboratively by the local community teams integrated with remote specialist oncology services. A 77-year-old patient presented with symptoms of cauda equina secondary to a large metastatic sacral deposit. The deposit was biopsied, and histology revealed a diagnosis of differentiated follicular thyroid cancer that was treated with external beam radiotherapy and thyroidectomy, followed by radioiodine. However, the disease was found to be resistant to radioiodine therapy, and the patient subsequently developed back pain due to new bone metastases. After further palliative external beam radiotherapy, the patient was started on systemic treatment with lenvatinib. Treatment has continued for more than 2.5 years with a slow but steady improvement in symptoms and quality of life. Monitoring and assessment of lenvatinib therapy and management of associated toxicities was coordinated remotely from a specialist cancer center over 200 miles away, using the skills of the local medical and nursing teams. This case report demonstrates how a cooperative effort using local teams and video-conferencing links to a specialist cancer center can be applied to safely treat a patient with a medication that may result in significant potential toxicities that require attentive and dynamic management.

scholarly journals Adjuvant External Beam Radiotherapy in Locally Advanced Differentiated Thyroid Cancer

2017 ◽  
Vol 143 (12) ◽  
pp. 1244 ◽  
Author(s):  
Samantha Tam ◽  
Moran Amit ◽  
Mongkol Boonsripitayanon ◽  
Maria E. Cabanillas ◽  
Naifa L. Busaidy ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
External Beam

External Beam Radiotherapy for Differentiated Thyroid Cancer

2010 ◽  
Vol 22 (6) ◽  
pp. 456-463 ◽  
Author(s):  
C. Powell ◽  
K. Newbold ◽  
K.J. Harrington ◽  
S.A. Bhide ◽  
C.M. Nutting
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
External Beam Radiotherapy ◽  
External Beam

The role of external beam radiotherapy in the management of differentiated thyroid cancer

2000 ◽  
Vol 54 (6) ◽  
pp. 345-349 ◽  
Author(s):  
R. Mazzarotto ◽  
M.G. Cesaro ◽  
O. Lora ◽  
D. Rubello ◽  
D. Casara ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
External Beam Radiotherapy ◽  
External Beam

Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer

2009 ◽  
Vol 48 (03) ◽  
pp. 89-98 ◽  
Author(s):  
M. K. Pixberg ◽  
B. Riemann ◽  
A. Schuck ◽  
A. Heinecke ◽  
K. W. Schmid ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Differentiated Thyroid Cancer ◽  
Regional Lymph Node ◽  
Statistical Significance ◽  
External Beam Radiotherapy ◽  
Distant Metastases ◽  
External Beam ◽  
Node Metastases

Summary Aim: Evaluate the clinical benefit of external beam radiotherapy (RTx) for locally invasive thyroid carcinoma with follicular cell differentiation (DTC). Patients, methods: The Multicentre Study on Differentiated Thyroid Cancer (MSDS) was planned as a prospective multicenter trial on the benefit of adjuvant RTx in locally invasive DTC (pT4; UICC 1997) with or without lymph node metastases and no known distant metastases. All patients were treated with thyroidectomy, 131I-therapy, and TSH-suppression and were randomized to receive additional RTx or not. In 4/2003 the trial became a prospective cohort study after only 45 of then 311 patients had consented to randomization. 351 of 422 patients met the trial's inclusion criteria. Age was 48 ± 12 years (mean ± SD). 25% were men. Tumours were papillary in 90% and follicular in 10%. Of 47 patients randomized or allocated to RTx, 26 actually received RTx. Results: Mean followup was 930 days. In an actual treatment analysis, 96% (25/26) of the RTx-patients reached complete remission (CR) vs. 86% in the non-RTx patients. Recurrences occurred in 0 vs. 3 % of patients: 6 reoperated for regional lymph node metastases, 1 tracheal invasion treated with tracheoplasty, 1 local invasion necessitating laryngectomy, 2 distant metastases (1 lung, 1 lung + bone). Serious chronic RTx toxicity occurred in 1/26 patients. Conclusion: The MSDS trial showed low mortality and recurrence rates and a weak benefit of RTx in terms of local control that did however not reach statistical significance. Routine RTx in locally invasive DTC can no longer be recommended .

scholarly journals PO-0709 External beam radiotherapy for metastatic lesions of differentiated thyroid cancer

2019 ◽  
Vol 133 ◽  
pp. S364-S365
Author(s):  
M. Kenji ◽  
Y. Hamamoto ◽  
Y. Urashima ◽  
N. Takata ◽  
K. Kikuchi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Metastatic Lesions

scholarly journals External-beam radiotherapy for differentiated thyroid cancer locoregional control: A statement of the American Head and Neck Society

Head & Neck ◽  
2015 ◽  
Vol 38 (4) ◽  
pp. 493-498 ◽  
Author(s):  
Ana P. Kiess ◽  
Nishant Agrawal ◽  
James D. Brierley ◽  
Umamaheswar Duvvuri ◽  
Robert L. Ferris ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Head And Neck ◽  
Differentiated Thyroid Cancer ◽  
External Beam Radiotherapy ◽  
Locoregional Control ◽  
External Beam

scholarly journals Differentiated Thyroid Cancer with Extrathyroidal Extension: Prognosis and the Role of External Beam Radiotherapy

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Michael A. Sia ◽  
Richard W. Tsang ◽  
Tony Panzarella ◽  
James D. Brierley
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Residual Disease ◽  
External Beam Radiotherapy ◽  
Local Relapse ◽  
Extrathyroidal Extension ◽  
External Beam ◽  
Locoregional Failure ◽  
Cause Specific Survival

A study was performed to identify variables that affected cause-specific survival (CSS) and local relapse-free rate (LRFR) in patients with differentiated thyroid cancer (DTC) and extrathyroid extension (ETE) and to examine the role of external beam radiotherapy (XRT). Prognostic factors were similar to those found in studies of all patients with DTC. In patients with postoperative gross residual disease treated with radiotherapy, 10-year CSS and LRFR were 48% and 90%. For patients with no residual or microscopic disease, 10-year CSS and LRFR were 92% and 93%. In patients older than 60 years with T3 ETE but no gross residual disease postoperatively there was an improved LRFR at 5 years of 96%, compared to 87.5% without XRT (P=.02). Patients with gross ETE benefit from XRT and there may be a potential benefit in reducing locoregional failure in patients over 60 years with minimal extrathyroidal extension (T3).

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