Benjamin D. Rosenbluth, M. D. , Victoria Serrano, B. S

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Intensity-modulated radiation therapy for the treatment of nonanaplastic thyroid cancer Benjamin D. Rosenbluth, M.D., Victoria Serrano, B.S., Laura Happersett, M.S., M.A., Ashok R. Shaha, M.D., R. Michael Tuttle, M.D., Ashwatha Narayana, M.D., Suzanne L. Wolden, M.D., Kenneth E. Rosenzweig, M.D., Lanceford M. Chong, M.D., Nancy Y. Lee, M.D. International Journal of Radiation Oncology • Biology • Physics Volume 63, Issue 5, Pages 1419-1426 (December 2005) DOI: 10.1016/j.ijrobp.2005.05.043 Copyright © 2005 Elsevier Inc. Terms and Conditions

Fig. 1 A 73-year-old woman with multiply recurrent papillary thyroid carcinoma (tall-cell variant) presented with gross disease recurrence in the right tracheoesophageal groove. Intraoperatively, the disease was adherent to the trachea and esophagus and was deemed unresectable. She received 59.4 Gy to the upper neck and mediastinum, and 70 Gy to the area of gross disease, in 33 fractions, using a “dose-painting” technique. (a) A high-neck axial slice, demonstrating the planning target volume (PTV)59.4 (red) and parotid (cyan and pink) contours, and representative isodose curves. (b) Upper mediastinal axial slice, demonstrating the PTV59.4 (red) and PTV70 (green) contours, plus isodose curves. (c) Sagittal slice, demonstrating the PTV59.4 (red) and PTV70 (green) contours, plus isodose curves. (d) Dose–volume histogram for the patient’s treatment plan. International Journal of Radiation Oncology • Biology • Physics 2005 63, 1419-1426DOI: (10.1016/j.ijrobp.2005.05.043) Copyright © 2005 Elsevier Inc. Terms and Conditions

Fig. 2 (a) Kaplan-Meier graph showing 2-year local control (LC) rate for all histologies. (b) Graph showing 2-year LC rate for papillary carcinoma vs. all other histologies. International Journal of Radiation Oncology • Biology • Physics 2005 63, 1419-1426DOI: (10.1016/j.ijrobp.2005.05.043) Copyright © 2005 Elsevier Inc. Terms and Conditions

Fig. 3 (a) Kaplan-Meier graph showing 2-year overall survival (OS) rate for all histologies. (b) Graph showing 2-year OS rate for papillary carcinoma vs. all other histologies. International Journal of Radiation Oncology • Biology • Physics 2005 63, 1419-1426DOI: (10.1016/j.ijrobp.2005.05.043) Copyright © 2005 Elsevier Inc. Terms and Conditions

Fig. 4 (a) Kaplan-Meier graph showing 2-year distant metastasis (DM)-free survival for all histologies. (b) Graph showing 2-year DM-free survival for papillary carcinoma vs. all other histologies. International Journal of Radiation Oncology • Biology • Physics 2005 63, 1419-1426DOI: (10.1016/j.ijrobp.2005.05.043) Copyright © 2005 Elsevier Inc. Terms and Conditions