Carcinoma epidermoide de tiroides localmente avanzado irresecable tratado con quimio-radioterapia radical / Unreseccable locally advanced thyroid squamous carcinoma treated with radical chemio-radiotherapy

Se presenta el caso de una mujer de 71 años que, a raíz de un cuadro de disfonía y opresión cervical, es diagnosticada de carcinoma epidermoide del estrecho torácico superior, de origen tiroideo como opción más probable. La singularidad de la histología en esta localización hace difícil filiar la masa, por lo que se plantean dos posibles opciones como origen del tumor primario: carcinoma epidermoide de tráquea versus carcinoma epidermoide primario de tiroides, siendo esta última estirpe extremadamente poco frecuente. A esta condición se le añade el carácter multidisciplinar en el proceso diagnóstico con la implicación de varias especialidades en el caso y la excelente respuesta al tratamiento no quirúrgico. Se trata de un caso de curación mediante quimio-radioterapia concomitante dada la condición de irresecable al diagnóstico, con evidente respuesta tanto clínica como radiológica en las sucesivas consultas hasta el momento actual, que continúa en seguimiento. (AU)

We present the case of a 71-year-old woman who, due to symptoms of hoarseness and cervical oppression, was diagnosed with squamous cell carcinoma of the upper thoracic outlet, of thyroid origin as the most likely option. The singularity of the histology in this location makes it difficult to identify the mass, which is why two possible options are considered as the origin of the primary tumor: squamous cell carcinoma of the trachea versus primary squamous cell carcinoma of the thyroid, the latter being an extremely rare lineage.To this condition is added the multidisciplinary nature of the diagnostic process with the involvement of various specialties in the case and the excellent response to non-surgical treatment. This is a case of cure by means of concomitant chemo-radiotherapy given the unresectable condition at diagnosis, with an evident clinical and radiological response in successive consultations up to the present time, which continues under follow-up. (AU)

Stereotactic body radiotherapy for early-stage non-small cell lung cancer: a multicentre study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society).

PURPOSE/OBJECTIVE(S): Stereotactic body radiotherapy (SBRT) has become the standard of care for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and for patients who refuse surgery. The aim of this study was to evaluate the effectiveness and safety of primary SBRT in patients with early-stage NSCLC. MATERIALS/METHODS: Retrospective multicenter study of 397 patients (416 primary lung tumours) treated with SBRT at 18 centres in Spain. 83.2% were men. The median age was 74.4 years. In 94.4% of cases, the tumour was inoperable. The pathological report was available in 54.6% of cases. SPSS vs 22.0. was used to perform all statistical analyses. RESULTS: Complete response was obtained in 53.6% of cases. Significant prognostic factors were standard CT planning (p = 0.014) and 4D cone beam CT (p = 0.000). Acute and chronic toxicity ≥ grade 3 was observed in 1.2% of cases. At a median follow-up of 30 months, local relapse was 9.6%, lymph node relapse 12.8%, distant metastasis 16.6%, and another lung tumour 11.5%. Complete response was the only significant prognostic factor for local relapse (p = 0.012) and distant metastasis (p = 0.001). The local relapse-free survival was 88.7%. The overall survival was 75.7%. The cancer-specific survival was 92.7%. The disease-free survival was 78.7%. CONCLUSION: SBRT is an effective and well-tolerated treatment option for patients with early-stage lung cancer who are not suitable for surgery. The most important prognostic factor for local and distant recurrence was complete response, which in our sample depended on the type of CT planning and the IGRT technique.