Abstract:

External beam radiotherapy (EBRT) is one of the important treatment methods for head and neck malignant tumors. However, EBRT in differentiated thyroid cancer (DTC) has remained controversial for decades. In 2025, the American Thyroid Association (ATA) updated its clinical practice guidelines for the management of DTC in adults, which is known as the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer (abbreviation ATA guideline). In recent years, various emerging radiotherapy techniques, such as intensity modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT), have been applied in DTC and have achieved positive results. Compared with the 2015 ATA guideline, the revised guidelines adopt a more permissive perspective on EBRT, underscoring the importance of modern radiotherapy techniques and individualized indications. Notably, the recommendations now include the use of EBRT in the management of oligometastatic disease or SBRT. This article compared the2025 ATA guideline with 2015 ATA guideline, then provides a systematic interpretation of the section on EBRT, aiming to provide evidence-based foundation for clinical practice.

Key words: Differentiated thyroid cancer, External beam radiotherapy, Oligometastasis, Intensity-modulated radiotherapy, Stereotactic body radiotherapy, Guideline interpretation