Favourable course of disease after incomplete remission on 131I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up

Abstract

In spite of incomplete remission of thyroid cancer at cessation of RIT, a continuing spontaneous decline of TG and clinically stable partial remissions were observed in this collective of children. Therefore, if RIT does not show further effects, the administration of further courses should be handled restrictively.

Determinants of successful ablation and complete remission after total thyroidectomy and 131I therapy of paediatric differentiated thyroid cancer

“…Even if it could be suspected that the patients would likely have done well with less aggressive treatment in terms of frequently repeated RIT courses, the present population cannot serve to show that this is in fact the case. Considering the present and other good long-term results in patients who do not reach [8,10,11], it might however not be unreasonable to exercise some patience before indicating further courses of RIT, only doing so after monitoring the trend of Tg levels after RIT. Eventually, whether the chance of reaching CR and the potential benefits outweigh the risks and side effects associated with further high-activity 131 I therapy courses will need to remain a patient-tailored, individualized decision.…”

“…Especially after the combination of total thyroidectomy and subsequent 131 I therapy (radioimmunotherapy, RIT), recurrence after complete remission (CR), progressive disease in patients with incomplete remission after initial therapy or DTC-related death are rare in children [5][6][7][8][9]. Even 131 I-refractory paediatric DTC patients often survive without disease progression with only thyroid-stimulating hormone (TSH) suppressive therapy [8,10,11] which is in stark contrast to the situation in adults.…”

Pediatric papillary thyroid cancer: current management challenges

“…In such patients, a long time after the last course of I-131 therapy further signs of disease remission such as reduced I-131 uptake on diagnostic whole body scintigraphy or a further reduction of Tg levels are seen 71. Likely these effects are at least in part attributable to continuous TSH suppression in these patients.…”

Thyroid cancer in children: a 20-year study at a Romanian oncology institute

“…Lymph node involvement at diagnosis is very frequent in children [17,22,24,25]. Distant metastases, most commonly to the lungs, are present in 20-30% of cases [26][27][28][29][30][31]. Longterm follow-up data show 20-year survival rates of 90-99% for children with DTC [18,25], but up to 30% of children with DTC have recurrent disease [32].…”