Radiotherapy in thyroid cancer

Although resection is the mainstay of treatment of thyroid cancer, and radioactive iodine (131-1) is curative in a small number of patients with differentiated cancers, external irradiation is much more effective than is generally believed. This has been clearly shown in a review of 138 patients with thyroid cancer referred to a cancer centre, in most cases after an initial operation. External irradiation should be considered in all patients except those with pure papillary tumours that have been completely excised. It should be used (a) in conjunction with surgery if there is even a remote doubt as to the completeness of excision; (b) in conjunction with 131-1 in treating inoperable primary tumours or metastatic lesions; () alone for differentiated tumours (primary or metastatic) that do not take up 131-1; and, (d) perhaps combined with chemotherapy, for medullary and anaplastic tumours.