How would you approach a locally advanced, radioiodine naive papillary thyroid carcinoma not amenable to a non-morbid surgery?
Have you seen RAI or lenvatinib be efficacious for locally advanced disease — allowing for better surgical outcomes? Do you utilize EBRT?
Answer from: Medical Oncologist at Community Practice
In certain cases there may a be a potential benefit. We have an 87 year old male with significant co-morbidities that prevented him from being a surgical candidate. Stage 4 papillary thyroid cancer with 1.7 cm right thyroid primary, 2.5 cm RML lung mass and 5 cm right cervical neck ...
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Answer from: Medical Oncologist at Community Practice
RAI prior to total thyroidectomy is of no benefit and may be toxic. Pre-op TKI should not be considered outside of clinical trial. There are some successful case reports of this approach in literature but I am not aware of any trials looking into this. I am unclear as to why this tumor is unresectab...
Comments
Medical Oncologist at Kaiser Permanente
Tumor oriented and can be resected but likely requ...
Tumor oriented and can be resected but likely requ...
Medical Oncologist at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Would biopsy again and make sure there is no anapl...
Would biopsy again and make sure there is no anapl...
Answer from: Radiation Oncologist at Academic Institution
There is no proven role for preoperative RAI in patients with unresectable iodine-avid well-differentiated thyroid cancer. The penetration of the isotope is minimal and the high likelihood of glandular edema resulting from the treatment would be morbid. I have no experience with neoadjuvant sy...