Survival advantage of chemoradiotherapy in anaplastic thyroid carcinoma: Propensity score matched analysis with multiple subgroups

• Type of Material: Article
• Authors: Sibo Tian, Emory University; Jeffrey Switchenko, Emory University; Teng Fei, Emory University; Robert H. Press, Emory University; Mustafa Abugideiri, Emory University; Nabil Saba, Emory University; Taofeek Owonikoko, Emory University; Amy Chen, Emory University; Jonathan Beitler, Emory University; Walter Curran Jr, Emory University; Theresa Gillespie, Emory University; Kristin Higgins, Emory University
• Language: English
• Date: 2019-12-16
• Publisher: WILEY
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Wiley Periodicals, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1002/hed.26042
• Title of Journal or Parent Work: HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
• Volume: 42
• Issue: 4
• Start Page: 678
• End Page: 687
• Grant/Funding Information: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute and NIH/NCI under award number P30CA138292.
• Keywords: chemoradiation; COMBINATION; Science & Technology; PACLITAXEL; anaplastic thyroid carcinoma; CANCER; RADIOTHERAPY; Surgery; Otorhinolaryngology; PATTERNS; Life Sciences & Biomedicine; chemotherapy; CARE; national cancer data base; SURGERY; CHEMOTHERAPY; TREATMENT OUTCOMES; radiation therapy; RADIATION
• Research Categories: Health Sciences, Rehabilitation and Therapy; Health Sciences, Medicine and Surgery; Biology, Radiation; Health Sciences, Oncology

Abstract

Background: We compared overall survival (OS) between radiation therapy (RT) and chemoradiotherapy (CRT) in patients with anaplastic thyroid carcinoma (ATC) using a large database. Methods: The National Cancer Data Base was queried for ATC patients diagnosed between 2004 and 2013 who received RT or CRT. Groups were balanced by propensity score matching (PSM) on nine relevant variables. OS was also examined in five paired subgroups given known patient heterogeneity. Results: Of 858 total patients, 575 received CRT and 283 received RT. CRT was associated with decreased risk of death (hazard ratio [HR] 0.66, P <.001), 1-year OS 25.5% vs 14.3%. A survival advantage to CRT was seen using PSM cohorts (HR 0.75, P =.006). Those receiving definitive surgery saw the greatest benefit to CRT over RT (HR 0.65, P =.009), 1-year OS 39.6% vs 20.4%. Conclusions: CRT is associated with decreased risk of death in ATC; the magnitude of CRT vs RT benefit varied by subgroup.