{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T09:34:52Z","timestamp":1793266492289,"version":"4.5.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Cancer Center Support Grant from the National Cancer Institute","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>External beam radiotherapy (RT) is indicated for high-risk, gross residual, unresected, or recurrent differentiated thyroid cancer (DTC) when further surgery is not recommended. Although RT improves time to locoregional control (LRC), head and neck toxicities remain a significant concern. Whether field reduction can lessen toxicity while maintaining tumor control in advanced DTC remains undefined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this retrospective cohort study, detailed RT plans were available for 284 of 327 consecutive nonanaplastic, nonmedullary DTC patients treated from 1999 to 2023 at a single tertiary center. Treatment fields were classified as: comprehensive (bilateral central compartment and bilateral necks), ipsilateral (central compartment plus ipsilateral neck), or central (central compartment only). Acute toxicities were defined as the worst grade within 90 days of RT start (CTCAE) and late toxicities thereafter (RTOG). Time to locoregional recurrence (LRR) was assessed using cumulative incidence functions, treating death without LRR as a competing risk. Overall median follow-up was 8.9 years (interquartile range 5.3\u201312.7 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 284 patients, 103 (36%) received comprehensive, 116 (41%) ipsilateral, and 65 (23%) central fields. Group differences in acute grade \u2265 2 toxicities were observed in xerostomia (36% comprehensive, 17% ipsilateral, 16% central,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002), dysphagia (58% comprehensive, 48% ipsilateral, 36% central,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02), voice changes (39% comprehensive, 22% ipsilateral, 28% central,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02) and fatigue (41% comprehensive, 28% ipsilateral, 22% central,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02). Also differing was late grade \u2265 2 dysphagia (23% comprehensive, 6% ipsilateral, 8% central,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0004). Percutaneous endoscopic gastrostomy tube placement was higher in comprehensive versus central (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0003) and ipsilateral (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.019) fields. In-field failure rates were 11\/103 (10.7%) for comprehensive, 11\/116 (9.5%) for ipsilateral, and 5\/65 (7.7%) for central fields, with no difference in LRC across groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.88). Six patients with central RT developed out-of-field lateral neck recurrences, all successfully salvaged with surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Progressive RT field reduction in appropriately selected DTC patients was associated with significantly lower rates of acute and late toxicities without compromising LRC. These findings support individualized field selection and highlight the potential role of RT field de-escalation in this population. Prospective multicenter studies are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256261493011","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:36:49Z","timestamp":1791466609000},"page":"1178-1189","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Locoregional Control and Toxicity of Neck Radiation with Field Reduction in Advanced Differentiated Thyroid Carcinoma: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3866-8719","authenticated-orcid":false,"given":"Justin","family":"Choi","sequence":"first","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."},{"name":"College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA."},{"name":"Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Wang","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."},{"name":"Department of Radiation Oncology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Christopher","family":"Dee","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achraf","family":"Shamseddine","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Yu","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ma","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeem","family":"Riaz","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McBride","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1526-642X","authenticated-orcid":false,"given":"Zeinab","family":"Abou Yehia","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan L.","family":"Ho","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Dunn","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winston","family":"Wong","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Michael","family":"Tuttle","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Fagin","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Sabra","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Fish","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Cracchiolo","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Ganly","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok R.","family":"Shaha","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Wong","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"1.Surveillance Research Program NCI. 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