Indications for External Irradiation in Thyroid Cancer
preoperative therapy
in conjunction or in sequence with chemotherapy, particularly anaplastic carcinoma
primary therapy of thyroid cancer if unresectable locally, especially if I-131 does not concentrate into the tumor
bulky tumors large enough to be uncontrollable by I-131 therapy alone
residual bulky tumor in the central neck, tracheal area, esophageal area, or cervical nodal regions after thyroid surgery and removal of malignant cervical adenopathy that may not be controlled by I-131 alone
recurrent or metastatic thyroid cancer occurring after maximal I-131 therapy
continually recurring thyroid cancer regardless of I-131 uptake
superior vena cava syndrome
relief of pressure symptoms caused by soft tissue masses on vital structures
brain metastases
hepatic metastases if symptomatic or other treatment methods have failed
skeletal metastases with uptake of I-131 small or absent
skeletal metastases when there is concern about a pathologic fracture, regardless of I-131 uptake
