Science

Gustavo Viani: Can Radiotherapy Make the Difference in High-Risk Thyroid Cancer?

Gustavo Viani/sbradioterapia.com.br

Aug 15, 2025, 09:29

Gustavo Viani: Can Radiotherapy Make the Difference in High-Risk Thyroid Cancer?

Gustavo Viani, Associate Professor at Faculty of Medicine of Botucatu, São Paulo State University (UNESP), shared on LinkedIn about recent paper published in Wiley.

“New Evidence in High-Risk Thyroid Cancer: Can Radiotherapy Make the Difference?

Why does this study matter?

High-risk differentiated thyroid cancer (DTC) can be challenging — especially when there’s gross extrathyroidal extension, positive margins, aggressive histology, or extranodal spread. While guidelines don’t recommend routine external beam radiotherapy (EBRT), its role in selected cases remains controversial. This study sheds light on who may actually benefit.

Objective: To evaluate the outcomes and toxicities of adjuvant IMRT in patients with high-risk DTC

How was it done?

• Design: Retrospective, single-center (2011–2024)
• Patients: 59 high-risk DTC cases, most with ≥2 adverse features
• Treatment: IMRT with IGRT, 60–64 Gy to high-risk areas
• Follow-up: Median 53 months

What did it show?

• 5-year locoregional control: 89.3%
• 5-year overall survival: 84.6%
• Acceptable toxicity profile (Grade ≥3 acute skin toxicity 12%, dysphagia 10%)
• Most recurrences were salvageable surgically

Key Message

Adjuvant IMRT can provide excellent locoregional control with manageable toxicity in carefully selected high-risk DTC patients — especially those with gross extrathyroidal extension or aggressive histology

Take-home

This study reinforces that RT in DTC should not be routine, but targeted — for the right patient, it may prevent morbid recurrences and improve quality of life.”

Title: Adjuvant External Beam Radiotherapy in Differentiated Thyroid Cancers: An Audit of Clinical Practice, Adapting to New Evidence

Authors: Sarbani Ghosh Laskar, Samarpita Mohanty, Shwetabh Sinha, Anuj Kumar, Gouri Pantvaidya, Shivakumar Thiagarajan, Ashwini Budrukkar, Monali Swain, Anuja Deshmukh, Deepa Nair, Richa Vaish, Vidisha Tuljapurkar, Chandrashekhar Dravid, Sudhir Nair, Poonam Joshi, Rathan Shetty, Arjun Gurmeet Singh, Pankaj Chaturvedi