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Master Thesis

Indications de la radiothérapie externe cervicale des cancers de la thyroïde de souche folliculaire : étude multicentrique rétrospective de 107 patients coordonnée par le réseau Tuthyref, revue systématique de la littérature, détermination des indications thérapeutiques basées sur un consensus d’experts

Abstract : Background: the role of external beam radiotherapy (EBRT) in differentiated thyroid cancer (DTC) is inaccurately defined in current guidelines. We assumed that this issue might be responsible of a high heterogeneity in the use of EBRT for DTC depending on clinicians and/or centres and requires a consensual expert’s agreement. The Tuthyref network group (the French Thyroid working group) aimed to better define the indications for EBRT in DTC. Materials and methods: firstly, based on published series, we performed a systematic review of literature to determine the available evidence of the role of EBRT for DTC. Finally, we only considered the comparative studies in which radioactive iodine (RAI) was routinely administered in order to interpret the results in accordance with the most recent therapeutic care. In a second part, an expert panel composed of 16 members originating from 13 different French centres evaluated the potential indications of EBRT for DTC. A substantial agreement (> 80%) was mandatory to establish the indications. Results: no randomized control trial was available. Comparative retrospective studies showed an improved loco-regional control with the addition of EBRT for DTC without any beneficial effect on survival. As the results differ between series, subgroup analyses failed to determine the subset of patients where EBRT would provide a benefit. A consensus agreement was reached to define relevant indications for EBRT in DTC. The resulting indications from the expert panel consensus were: (1) in the adjuvant setting, pT4 tumours with grossly positive margin (R2) and low/no radioiodine uptake, (2) for surgically unresectable loco-regional recurrences with low/no radioiodine uptake and (3) in the palliative setting, in case of aero-digestive compression. Conclusion: to our knowledge, this is the first substantial agreement about indications of EBRT for DTC, obtained from an expert panel. We hope our consensus statement will help clinicians in the multidisciplinary treatment management for patients with DTC.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01655317
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, December 4, 2017 - 5:56:31 PM
Last modification on : Thursday, December 14, 2017 - 1:15:48 AM

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Eivind Blais. Indications de la radiothérapie externe cervicale des cancers de la thyroïde de souche folliculaire : étude multicentrique rétrospective de 107 patients coordonnée par le réseau Tuthyref, revue systématique de la littérature, détermination des indications thérapeutiques basées sur un consensus d’experts. Médecine humaine et pathologie. 2017. ⟨dumas-01655317⟩

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