Decreasing utilization for postoperative radiation therapy in locoregionally advanced medullary thyroid cancer

Anastasios Maniakas; Andrew Sullivan; Mimi I. Hu; Naifa L. Busaidy; Maria E. Cabanillas; Ramona Dadu; Steven G. Waguespack; Sarah B. Fisher; Paul H. Graham; Neil D. Gross; Elizabeth G. Grubbs; Nancy D. Perrier; Jennifer R. Wang; Brandon Gunn; Adam S. Garden; Romy Megahed; Sriram Navuluri; Xu Li; Michelle D. Williams; Mark Zafereo

doi:10.1002/hed.27584

Decreasing utilization for postoperative radiation therapy in locoregionally advanced medullary thyroid cancer

Anastasios Maniakas, Andrew Sullivan, Mimi I. Hu, Naifa L. Busaidy, Maria E. Cabanillas, Ramona Dadu, Steven G. Waguespack, Sarah B. Fisher, Paul H. Graham, Neil D. Gross, Elizabeth G. Grubbs, Nancy D. Perrier, Jennifer R. Wang, Brandon Gunn, Adam S. Garden, Romy Megahed, Sriram Navuluri, Xu Li, Michelle D. Williams, Mark Zafereo

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Use of postoperative radiation therapy (PORT) in locoregionally advanced medullary thyroid cancer (MTC) remains controversial. The objective was to evaluate the effect of PORT on locoregional control (LRC) and overall survival (OS). Methods: Retrospective cohort study of 346 MTC patients separated into PORT and no-PORT cohorts. Relative indications for PORT, as well as changes in patterns of treatment, were recorded. Results: 49/346 (14%) received PORT. PORT was associated with worse OS; adjusted HR = 2.0 (95%CI 1.3–3.3). PORT was not associated with improved LRC, even when adjusting for advanced stage (Stage III p = 0.892; Stage IV p = 0.101). PORT and targeted therapy were not associated with improved OS compared to targeted therapy alone; adjusted HR = 1.2 (95%CI 0.3–4.1). Conclusions: Use of PORT in MTC has decreased and its indications have become more selective, coinciding with the advent of effective targeted therapies. Overall, PORT was not associated with improved LRC or OS.

Original language	English (US)
Pages (from-to)	328-335
Number of pages	8
Journal	Head and Neck
Volume	46
Issue number	2
DOIs	https://doi.org/10.1002/hed.27584
State	Published - Feb 2024

Keywords

locoregional control
medullary thyroid cancer
overall survival
postoperative radiation therapy
targeted therapy

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.27584

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Maniakas, A., Sullivan, A., Hu, M. I., Busaidy, N. L., Cabanillas, M. E., Dadu, R., Waguespack, S. G., Fisher, S. B., Graham, P. H., Gross, N. D., Grubbs, E. G., Perrier, N. D., Wang, J. R., Gunn, B., Garden, A. S., Megahed, R., Navuluri, S., Li, X., Williams, M. D., & Zafereo, M. (2024). Decreasing utilization for postoperative radiation therapy in locoregionally advanced medullary thyroid cancer. Head and Neck, 46(2), 328-335. https://doi.org/10.1002/hed.27584

Maniakas, A, Sullivan, A, Hu, MI , Busaidy, NL , Cabanillas, ME , Dadu, R , Waguespack, SG , Fisher, SB , Graham, PH , Gross, ND , Grubbs, EG , Perrier, ND , Wang, JR , Gunn, B , Garden, AS, Megahed, R, Navuluri, S, Li, X, Williams, MD & Zafereo, M 2024, 'Decreasing utilization for postoperative radiation therapy in locoregionally advanced medullary thyroid cancer', Head and Neck, vol. 46, no. 2, pp. 328-335. https://doi.org/10.1002/hed.27584

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title = "Decreasing utilization for postoperative radiation therapy in locoregionally advanced medullary thyroid cancer",

abstract = "Background: Use of postoperative radiation therapy (PORT) in locoregionally advanced medullary thyroid cancer (MTC) remains controversial. The objective was to evaluate the effect of PORT on locoregional control (LRC) and overall survival (OS). Methods: Retrospective cohort study of 346 MTC patients separated into PORT and no-PORT cohorts. Relative indications for PORT, as well as changes in patterns of treatment, were recorded. Results: 49/346 (14%) received PORT. PORT was associated with worse OS; adjusted HR = 2.0 (95%CI 1.3–3.3). PORT was not associated with improved LRC, even when adjusting for advanced stage (Stage III p = 0.892; Stage IV p = 0.101). PORT and targeted therapy were not associated with improved OS compared to targeted therapy alone; adjusted HR = 1.2 (95%CI 0.3–4.1). Conclusions: Use of PORT in MTC has decreased and its indications have become more selective, coinciding with the advent of effective targeted therapies. Overall, PORT was not associated with improved LRC or OS.",

keywords = "locoregional control, medullary thyroid cancer, overall survival, postoperative radiation therapy, targeted therapy",

author = "Anastasios Maniakas and Andrew Sullivan and Hu, {Mimi I.} and Busaidy, {Naifa L.} and Cabanillas, {Maria E.} and Ramona Dadu and Waguespack, {Steven G.} and Fisher, {Sarah B.} and Graham, {Paul H.} and Gross, {Neil D.} and Grubbs, {Elizabeth G.} and Perrier, {Nancy D.} and Wang, {Jennifer R.} and Brandon Gunn and Garden, {Adam S.} and Romy Megahed and Sriram Navuluri and Xu Li and Williams, {Michelle D.} and Mark Zafereo",

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year = "2024",

month = feb,

doi = "10.1002/hed.27584",

language = "English (US)",

volume = "46",

pages = "328--335",

journal = "Head and Neck",

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T1 - Decreasing utilization for postoperative radiation therapy in locoregionally advanced medullary thyroid cancer

AU - Maniakas, Anastasios

AU - Sullivan, Andrew

AU - Hu, Mimi I.

AU - Busaidy, Naifa L.

AU - Cabanillas, Maria E.

AU - Dadu, Ramona

AU - Waguespack, Steven G.

AU - Fisher, Sarah B.

AU - Graham, Paul H.

AU - Gross, Neil D.

AU - Grubbs, Elizabeth G.

AU - Perrier, Nancy D.

AU - Wang, Jennifer R.

AU - Gunn, Brandon

AU - Garden, Adam S.

AU - Megahed, Romy

AU - Navuluri, Sriram

AU - Li, Xu

AU - Williams, Michelle D.

AU - Zafereo, Mark

PY - 2024/2

Y1 - 2024/2

N2 - Background: Use of postoperative radiation therapy (PORT) in locoregionally advanced medullary thyroid cancer (MTC) remains controversial. The objective was to evaluate the effect of PORT on locoregional control (LRC) and overall survival (OS). Methods: Retrospective cohort study of 346 MTC patients separated into PORT and no-PORT cohorts. Relative indications for PORT, as well as changes in patterns of treatment, were recorded. Results: 49/346 (14%) received PORT. PORT was associated with worse OS; adjusted HR = 2.0 (95%CI 1.3–3.3). PORT was not associated with improved LRC, even when adjusting for advanced stage (Stage III p = 0.892; Stage IV p = 0.101). PORT and targeted therapy were not associated with improved OS compared to targeted therapy alone; adjusted HR = 1.2 (95%CI 0.3–4.1). Conclusions: Use of PORT in MTC has decreased and its indications have become more selective, coinciding with the advent of effective targeted therapies. Overall, PORT was not associated with improved LRC or OS.

AB - Background: Use of postoperative radiation therapy (PORT) in locoregionally advanced medullary thyroid cancer (MTC) remains controversial. The objective was to evaluate the effect of PORT on locoregional control (LRC) and overall survival (OS). Methods: Retrospective cohort study of 346 MTC patients separated into PORT and no-PORT cohorts. Relative indications for PORT, as well as changes in patterns of treatment, were recorded. Results: 49/346 (14%) received PORT. PORT was associated with worse OS; adjusted HR = 2.0 (95%CI 1.3–3.3). PORT was not associated with improved LRC, even when adjusting for advanced stage (Stage III p = 0.892; Stage IV p = 0.101). PORT and targeted therapy were not associated with improved OS compared to targeted therapy alone; adjusted HR = 1.2 (95%CI 0.3–4.1). Conclusions: Use of PORT in MTC has decreased and its indications have become more selective, coinciding with the advent of effective targeted therapies. Overall, PORT was not associated with improved LRC or OS.

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KW - medullary thyroid cancer

KW - overall survival

KW - postoperative radiation therapy

KW - targeted therapy

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Decreasing utilization for postoperative radiation therapy in locoregionally advanced medullary thyroid cancer

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