Results
liver (10%).Recurrent laryngeal nerve palsy, erythema, disseminated disease, death
METASTASIS, ADVERSE EVENTS, ERYTHEMA, SKIN TOXICITY, METASTASES
Characteristics of enrolled patients are presented in Table Patients baseline characteristics (n = 63)* percentage for patients with reported N-stage (n = 40). IMRT = Intensity modulated radiotherapy. VMAT = Volumetric modulated arc therapy. ATC = Anaplastic thyroid cancerAll cases had UICC-status IV (8th edition) [The Karnofsky performance status was reported for 20 patients and was 60 in the median.We had data about lymph node involvement for 40 patients, from which 67.5% had effected lymph nodes and 32.5% had N0.Distant metastases were found in 44% at the time of diagnosis and in 41% in the course of treatment. The main localization of metastasis were the lungs in 63% of all cases, bones (21%), central nervous system (14%), extracervical lymph nodes (13%) and liver (10%).Recurrent laryngeal nerve palsy the time of radiotherapy was reported for 31 cases (49%). Out of all patients, 76% underwent surgery (52% total, 16% subtotal thyroidectomy, 8% hemithyroidectomy). In 12.5% R0 (no margins) was achieved. A resection status of R1 was reached in 12.5% and R2 in 58%. In 17% the resection status could not be determined.Molecular Testing was reported for two patients. One was BRAF and MEK negative and received Lenvatinib and Pembrolizumab. The other patient was TP53 positive, this did not lead to any targeted therapy.Targeted therapy was given to three patients. They received Pembrolizumab and Lenvatinib.Chemotherapy was administered to 15 patients (24%), of which 11 (17%) got simultaneous radiotherapy. In detail, (radio)chemotherapy was given to seven patients with disseminated disease. Six patients had no metastases and received curative (radio)chemotherapy. The most frequently used chemotherapeutics were Carboplatin, Cisplatin, Paclitaxel and Doxorubicin, in mono- or combined therapy. Radiotherapy (RT) was delivered to 62 patients; one refused the radiation. 32% of the patients were irradiated via opposing-field technique, 18% with 3D-conformal technique and 27% with a combination of both. In 15%, volumetric modulated arc therapy (VMAT) and in 6%, intensity modulated radiation therapy (IMRT) technique was applied. The median total dose was 49 Gy with a range from 4 to 66 Gy. In ten patients (16%) the radiotherapy had to be terminated prematurely due to a deterioration of health condition or death. For 15 patients (24%) a tracheostomy was performed. We described toxic side effects using grades according to the common terminology criteria of adverse events (CTCAE), version 5.0 [Skin toxicity was reported in CTCAE grade 1, 2 and 3 in 21%, 37% and 18%. Seven patients (11%) had no erythema and for eight it was not reported.