ArticleFrontiers in oncology2026
Local control after stereotactic radiation for thyroid cancer: a histology risk-stratified analysis.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose/Objectives: Recurrent and metastatic non-anaplastic thyroid cancer has traditionally been considered relatively radioresistant. We evaluated whether anatomic site or histology risk group better predicts local control (LC) following stereotactic radiation therapy (SBRT/SRS). Materials/Methods: We retrospectively reviewed 32 patients with 66 treated lesions (42 skeletal, 24 non-skeletal) treated between 2012 and 2025. Histology was dichotomized into low-risk (papillary, follicular, medullary, Hürthle cell; n=61) and high-risk (poorly differentiated and squamous cell carcinoma; n=5). BED Results: Median follow-up was 15.0 months. Six local failures occurred (crude LC 90.9%); 1- and 2-year LC were 96.5% and 87.1%. Histology risk was the dominant determinant: low-risk histology achieved 95.1% crude LC versus 40.0% for high-risk (log-rank p=0.002). In multivariable GEE analysis, low-risk histology was independently associated with LC (OR 158.0, 95% CI 1.72-14,479.7; p=0.028), whereas skeletal site was not (OR 1.07, 95% CI 0.02-51.8; p=0.974). BED Conclusion: In stereotactic radiation for metastatic non-anaplastic thyroid cancer, histology risk grouping-not anatomic site or dose escalation-is the dominant predictor of local control. These findings support histology-based risk stratification for SRT patient selection.
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