Charged particle radiotherapy for thyroid cancer. A systematic review

Area of Science:

• Oncology
• Radiotherapy
• Nuclear Medicine

Background:

• The role of external beam radiotherapy (EBRT) in thyroid cancer (TC) management is not well-established due to limited evidence.
• Retrospective data suggest potential benefits of adjuvant EBRT for high-risk differentiated thyroid cancer (DTC) and limited-stage anaplastic thyroid carcinoma (ATC).

Purpose of the Study:

• To review and synthesize current evidence on the role of advanced radiotherapy techniques in thyroid cancer treatment.
• To evaluate the efficacy and safety of intensity-modulated radiotherapy (IMRT) and particle therapy (PT) in managing different types of thyroid cancer.

Main Methods:

• Systematic literature review adhering to PRISMA guidelines.
• Analysis of 471 studies published between January 2002 and January 2024, selecting 14 relevant articles (10 preclinical, 4 clinical).
• Inclusion of studies on various particle therapies (protons, carbon ions, BNCT) and photon-based radiotherapy.

Main Results:

• Preclinical studies, particularly on Boron Neutron Capture Therapy (BNCT) in anaplastic thyroid carcinoma (ATC) mouse models, demonstrated promising local control.
• Clinical studies involving proton, neutron, or photon radiotherapy reported favorable treatment outcomes and acceptable toxicity profiles.
• Adjuvant EBRT, when combined with surgery and chemotherapy, may enhance locoregional control and progression-free survival in specific high-risk TC cases.

Conclusions:

• Particle therapy (PT) presents a promising approach for thyroid cancer treatment, supported by biological plausibility.
• Further clinical research is essential to definitively establish the role of PT and optimize its combination with systemic therapies for TC.
• Advanced radiotherapy techniques like IMRT and PT warrant continued investigation for improved thyroid cancer management.