INTRAOPERATIVE RADIATION-THERAPY, ENDOTRACHEAL HYPERTHERMIA AND IR-192-BRACHYTHERAPY IN PATIENTS WITH ADVANCED THYROID-CANCER

Tracheal stenosis due to infiltrative nonresectable thyroid cancer cau ses severe reduction in life quality. Palliative therapy, apart from t racheostomy is - up to now - intraluminal and/or external radiation. G ood tumor control is achieved by local hyperthermia. A combined modali ty treatment (CMT) consisting of surgery, brachytherapy and intraopera tive radiation, eventually combined with intraluminal NdYg-Laser-desob literation was performed. An intraoperative radiation therapy (IORT)-p rotocol was designed for poorly differentiated non-anaplastic thyroid carcinoma. Out of 155 cases of differentiated thyroid tumors, 12 showe d marked vascular and/or capsular invasion. Five entered the study (3 primarily local invasive tumors, 2 local recurring). IORT was administ ered after tumor surgery (4-10 Gy) and combined with postoperative per cutaneous irradiation. The tumor control rate in the thyroid bed is 5/ 5, 1/5 developed mediastinal nodes, 1/5 with primary mediastinal tumor extend shows tumor progression. No specific complications occurred.