방사선의학 웹진

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Abstract
Background: Medullary thyroid cancer (MTC) is a rare thyroid carcinoma that often presents at an advanced stage. The efficacy of adjuvant postoperative radiotherapy (PORT) in treating MTC remains a topic of debate. We aimed to assess whether PORT enhances survival outcomes in patients with MTC.

Methods: We conducted a systematic review of databases, including EMBASE, PubMed, Cochrane Library, and CINAHL to identify relevant studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and local recurrence-free survival (LRFS) were extracted, and pooled analyses were performed using random-effects models.

Results: Ten studies were finally included. Two separate pooled analyses of OS revealed no statistically significant differences between the PORT and observation groups (HR 1.59, 95% CI 0.87-2.92 and HR 1.67, 95% CI 0.92-3.02, including two different National Cancer Database studies with overlapping periods, respectively). Similarly, no significant differences were noted for LRFS (HR 0.90, 95% CI 0.44-1.82; I2 = 0%, p = 0.442).

Conclusions: Although PORT did not demonstrate significant differences in survival outcomes compared to observation, personalized treatment considerations are essential due to heterogeneity among high-risk patients. Further prospective studies are required to define optimal adjuvant treatment strategies for MTC.

Affiliations

Yu Jin Lim 1, Han Na Lee 2
1Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
2Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.