Usefulness of CyberKnife Therapy in Patients with Differentiated Thyroid Cancer with Distant Metastases

JOURNAL TITLE: An International Journal of Otorhinolaryngology Clinics

Author
1. Shigeaki Higashiyama
2. Takashi Yamanaga
3. Yutaka Katayama
4. Joji Kawabe
5. Atsushi Yoshida
ISSN
0975-444X
DOI
10.5005/jp-journals-10003-1352
Volume
12
Issue
2
Publishing Year
2020
Pages
4
Author Affiliations
    1. Department of Nuclear Medicine, Osaka City University, Graduate School of Medicine, Osaka-City, Osaka-Fu, Japan
    1. Department of Obstetrics and Gynecology, Nishisaitama-Chuo National Hospital, Saitama, Japan
    1. Department of Radiology, Osaka City University Hospital, Osaka-City, Osaka-Fu, Japan
    1. Department of Radiology, Osaka City University Hospital, Osaka-City, Osaka-Fu, Japan
    1. Department of Nuclear Medicine, Osaka City University, Graduate School of Medicine, Osaka-City, Osaka-Fu, Japan
  • Article keywords

    Abstract

    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.

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