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  • Author: Ewa Paliczka-Cieslik x
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Aleksandra Kukulska Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland
Radiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Jolanta Krajewska Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Zofia Kolosza Department of Epidemiology and Silesia Cancer Registry, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Ewa Paliczka-Cieslik Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Aleksandra Kropinska Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Agnieszka Pawlaczek Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Zbigniew Puch Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Kornelia Ficek Radiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Teresa Lisik Radiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Dorota Sygula Radiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Zbigniew Wygoda Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Jozef Roskosz Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Jerzy Wydmanski Radiotherapy Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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Barbara Jarzab Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland

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The value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differences in response to radiotherapy between hereditary and sporadic MTC.

Methods

A retrospective analysis involved 254 MTC patients, among them 73 patients with a hereditary disease. Two hundred and twenty-four patients, including 43 persons at a high risk of local relapse, underwent only initial surgery; 18 other patients were operated due to MTC recurrences, whereas the remaining 12 patients had cytoreductive procedure or were not amenable for surgery. Radiotherapy was carried out in 132 patients. One hundred and twenty patients underwent adjuvant radiotherapy, among them 102 patients after initial surgery. The median follow-up was 10 years (range 0.5–29 years).

Results

Local recurrence occurred in 107/254 patients, among them in 63 subjects after prior radiotherapy. The frequency of relapse showed significantly increasing trend toward higher MTC stages (P <0.001). More relapses occurred in patients with lymph node metastases present at MTC onset. Adjuvant radiotherapy was associated with a lower risk of nodal recurrence only in high-risk patients, particularly if lymph node metastases were present at MTC diagnosis. The differences between hereditary and sporadic subgroups were not significant.

Conclusions

Adjuvant radiotherapy has a limited importance in MTC treatment. It should be considered in high-risk MTC patients. The presence of RET mutation does not influence the response to radiation.

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