ETA2024 Poster Presentations Clinical thyroid cancer research-1 (10 abstracts)
Toxicity and quality of life after locoregional radiotherapy in patients with thyroid cancer
Job van den End 1 , Eline Jager 2 , Hans Verbeek 3 , Edwin Oldehinkel 4 , Liesbeth Jansen 5 , A.H. Brouwers 6 , Wouter Zandee 7 , Schelto Kruijff 8 & Thera Links 9
1University Medical Center Groningen, Endocrinology, Groningen, Netherlands; 2University Medical Center Groningen, Endocrinology / Surgical Oncology, Groningen, Netherlands; 3University Medical Center Groningen, Radiation Oncology, Groningen, Netherlands; 4University Medical Center Groningen, Radiation Oncology; 5University Medical Center Groningen, University Medical Center Groningen, Surgical Oncology, Groningen, Netherlands; 6University Medical Center Groningen, University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging Groningen, Groningen, Netherlands; 7University Medical Center Groningen, Groningen University, Groningen, Netherlands; 8University Medical Center Groningen, University Medical Center Groningen, Surgery, Groningen, Netherlands; 9University Medical Center Groningen, Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Department of Endocrinology, Groningen, Netherlands
Objectives: To analyze acute and late toxicities and long-term quality of life (QoL) in patients who underwent locoregional external beam radiotherapy (EBRT) for thyroid cancer and to assess the correlation of QoL with treatment characteristics.
Methods: Patients treated with locoregional EBRT for thyroid cancer at University Medical Centre Groningen (UMCG) (2007-2023) were included. Patient/treatment characteristics were extracted from patient files retrospectively. Acute (<6 weeks) and late (≥3 months) toxicities and QLQ-H&N35 results (pre-radiation and 6 months post-radiation), collected as standard part of patient care, were extracted from a prospective database. Additionally, living patients were asked to complete QLQ-H&N43 (renewed QLQ-H&N35 version) and SF-36-RAND-36, allowing a longitudinal comparison. Correlations were evaluated between questionnaire scores and EBRT techniques (IMRT vs VMAT) and other treatment characteristics.
Results: For the retrospective analysis, 66 patients were studied. In a subset of 31 patients that completed the questionnaires during EBRT prospectively, acute toxicities included: dermatitis (93%), pain (74%), hoarseness (71%), dysphagia (67%), tough mucus (56%), xerostomia (52%), change of taste (27%), and mucositis (26%). Late toxicity presented as persisting acute toxicity and fibrosis (65%). After six months, the QLQ-H&N35 domains ‘social eating’ (P = 0.031) and ‘dry mouth/sticky saliva’ (P = 0.025) were impaired, in comparison to pre-radiation. 25 of the 66 patients were alive at time of data collection and 17 of them filled in the two additional questionnaires. Long-term mitigation was not observed for the 10/17 patients that completed both QLQ-H&N35 and QLQ-H&N43. For the treatment characteristics, only VMAT was associated with an improved QLQ-H&N43 score, compared to IMRT (P = 0.047).
Conclusion: EBRT causes acute and late toxicities in most thyroid cancer patients and creates a decrease in their QoL. As these patients generally have relative high survival rates, there is a compelling need to minimize toxicities with more refined radiation techniques, such as proton therapy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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