Charged particle radiotherapy for thyroid cancer. A systematic review

Crit Rev Oncol Hematol. 2024 Oct:202:104463. doi: 10.1016/j.critrevonc.2024.104463. Epub 2024 Aug 2.

Abstract

The role of external beam radiotherapy (EBRT) in thyroid cancer (TC) remains contentious due to limited data. Retrospective studies suggest adjuvant EBRT benefits high-risk differentiated thyroid cancer (DTC) and limited-stage anaplastic thyroid carcinoma (ATC), enhancing locoregional control and progression-free survival when combined with surgery and chemotherapy. Intensity-modulated radiotherapy (IMRT) and particle therapy (PT), including protons, carbon ions, and Boron Neutron Capture Therapy (BNCT), represent advances in TC treatment. Following PRISMA guidelines, we reviewed 471 studies from January 2002 to January 2024, selecting 14 articles (10 preclinical, 4 clinical). Preclinical research focused on BNCT in ATC mouse models, showing promising local control rates. Clinical studies explored proton, neutron, or photon radiotherapy, reporting favorable outcomes and manageable toxicity. While PT shows promise supported by biological rationale, further research is necessary to clarify its role and potential combination with systemic treatments in TC management.

Keywords: Boron NEutron Capture therapy; Carbon ion radiotherapy; Heavy ion radiotherapy; Molecular targeted therapy; Proton radiation therapy; Proton therapy; Radiotherapy; Thyroid cancer.

Publication types

  • Systematic Review

MeSH terms

  • Animals
  • Boron Neutron Capture Therapy / adverse effects
  • Boron Neutron Capture Therapy / methods
  • Heavy Ion Radiotherapy / adverse effects
  • Heavy Ion Radiotherapy / methods
  • Humans
  • Proton Therapy / adverse effects
  • Proton Therapy / methods
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Radiotherapy, Intensity-Modulated / methods
  • Thyroid Neoplasms* / pathology
  • Thyroid Neoplasms* / radiotherapy