Clinical Study

18F-FDG Pet-Guided External Beam Radiotherapy in Iodine-Refractory Differentiated Thyroid Cancer: A Pilot Study

Table 5

Clinical studies: EBRT in locoregional differentiated thyroid cancer recurrence.

Author, yearMedical centerReferenceStudy designPatientsEBRT technique 
(target volumes and doses)

O’Connell et al., 1994Royal Marsden Hospital, London, UK[19]Retrospective11Bilateral neck and superior mediastinum with 60Co photons or 5 MV photons via AP/PA portals (60 Gy/30 daily fraction) or neck and superior mediastinum with 20 and 35 MeV electron beams, respectively (75 Gy/30 daily fraction)

Meadows et al., 2006University of Florida Health Science Center, USA[20]Retrospective20Thyroid bed, cervical lymph nodes, upper mediastinum with photons via 3-field (anterior field of 45 Gy, opposed lateral fields with bolus to boost the final tumor dose) or thyroid bed, cervical lymph nodes, upper mediastinum with IMRT (64.9 Gy at 1.8 to 2.0 Gy/daily fraction)

Kim et al., 2010Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea[21]Retrospective15Limited field: recurrent tumor bed and positive nodal area via 3DCRT or IMRT (median total dose of 62.5 Gy at 1.8 to 2.5 Gy/daily fraction) or elective field: recurrent tumor bed and regional nodal areas in the cervical neck and upper mediastinum via 3DCRT or IMRT (median total dose of 50 Gy and a median dose of 62.5 Gy to boost tumor bed and positive nodal area at 1.8 to 2.5 Gy/daily fraction)

Romesser et al., 2014Memorial Sloan Kettering Cancer Center, New York, USA[5]Retrospective36Low-risk areas to 54 Gy; high risk areas to 60 Gy; close or microscopically positive margins to 66 Gy and areas of gross disease to 70 Gy (total median dose of 66.3 Gy in a median of 33 fractions) via IMRT (majority of cases)

Current seriesBologna University, Bologna, ItalyPilot16FDG-PET positive areas to 66 Gy, ipsilateral lymph nodes to 60 Gy, contralateral nodes to 54 Gy, in 30 fractions via IMRT-SIB technique

3DCRT: three-dimensional conformal radiotherapy; ATC: anaplastic thyroid cancer; IMRT: intensity modulated radiotherapy; yrs: years.