Intraoperative radiation therapy, endotracheal hyperthermia and IR-192-brachytherapy in patients with advanced thyroid cancer.
الكلمات الدالة
نبذة مختصرة
Tracheal stenosis due to infiltrative nonresectable thyroid cancer causes severe reduction in life quality. Palliative therapy, apart from tracheostomy is--up to now--intraluminal and/or external radiation. Good tumor control is achieved by local hyperthermia. A combined modality treatment (CMT) consisting of surgery, brachytherapy and intraoperative radiation, eventually combined with intraluminal NdYg-Laser-desobliteration was performed. An intraoperative radiation therapy (IORT)-protocol was designed for poorly differentiated non-anaplastic thyroid carcinoma. Out of 155 cases of differentiated thyroid tumors, 12 showed marked vascular and/or capsular invasion. Five entered the study (3 primarily local invasive tumors, 2 local recurring). IORT was administered after tumor surgery (4-10 Gy) and combined with postoperative percutaneous irradiation. The tumor control rate in the thyroid bed is 5/5, 1/5 developed mediastinal nodes, 1/5 with primary mediastinal tumor extend shows tumor progression. No specific complications occurred.