Secondary thyroid carcinoma after treatment for childhood cancer

Black, Peter C.; Straaten, Antje; Gutjahr, P.

doi:10.1002/(sici)1096-911x(199808)31:2<91::aid-mpo8>3.0.co;2-u

Cited by 61 publications

(23 citation statements)

References 25 publications

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“…4,6,8 While thyroid carcinoma is an expected event after neck irradiation in Hodgkin's patients, 18,19 data on secondary thyroid cancer after chemotherapy in children with acute leukemia who did not undergo BMT, are scarce and show that this event is uncommon. 20,21 Therefore, our study suggests that the BMT procedure constitutes an excess risk for thyroid carcinogenesis.…”

Section: Discussionmentioning

confidence: 67%

Secondary thyroid carcinoma after allogeneic bone marrow transplantation during childhood

Cohen

Rovelli

Lint

et al. 2001

Bone Marrow Transplant

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Summary:The aim of this study was to evaluate the incidence and risk factors related to secondary thyroid carcinoma (STC) in patients who have undergone allogeneic BMT during childhood. Data related to the primary hematological disorder and BMT procedure were obtained from the records of 113 patients (42 F; 71 M) who underwent BMT before the age of 18 (median 10.0 years; range 1.7-18.0) and survived more than 3 years after transplant with a median follow-up of 10.1 years (range 3.0-19.0). Sixteen received cranial radiation (CRT) during first-line treatment. Pre-transplant conditioning included TBI in 85 patients, TAI in two, while 26 children did not receive irradiation. The standardized incidence ratio of STC after BMT was significantly higher (P Ͻ 0.001) than that of the general population. STC was found in eight patients, 3.1 to 15.7 years after transplant. All received TBI and three also CRT. The Cox's regression analysis, although not statistically significant due to the small study population, showed an increased risk in those who had received a cumulative radiation dose higher than 10 Gy and in those who developed chronic GVHD. Careful follow-up of thyroid status including annual ultrasound examination is recommended for early detection of tumor. Bone Marrow Transplantation (2001) 28, 1125-1128.

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Section: Discussionmentioning

confidence: 67%

Secondary thyroid carcinoma after allogeneic bone marrow transplantation during childhood

Cohen

Rovelli

Lint

et al. 2001

Bone Marrow Transplant

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“…14 Papillary carcinomas accounted for the majority of thyroid malignancies in the current study, corroborating the experience of others. 6,7,15,16 Patients with thyroid carcinoma were similar to patients with benign thyroid lesions in terms of their age at diagnosis, primary diagnosis of malignancy, gender, and length of follow-up. However, the patients who were diagnosed with thyroid carcinoma had received a slightly lower median dose of radiation to the thyroid compared with the patients who had benign disease (2000 cGy vs. 2950 cGy; P ϭ 0.03).…”

Section: Discussionmentioning

confidence: 92%

Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

Acharya

Sarafoglou

LaQuaglia

et al. 2003

Cancer

172

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BACKGROUNDRecent data indicate that the risk of developing a thyroid neoplasm clearly is increased after high‐dose, therapeutic radiation therapy during childhood. To better understand the time course, natural history, and histopathology of thyroid lesions that develop after high‐dose irradiation, the authors undertook a retrospective study of all survivors of childhood and adolescent malignancies who were treated at Memorial Sloan‐Kettering Cancer Center and who developed a clinically apparent thyroid neoplasm.METHODSThe authors searched the data base of the Department of Pediatrics, the hospital‐based tumor registry, and the hospital medical records database for patients with thyroid neoplasms.RESULTSThirty‐three patients were identified who developed a thyroid neoplasm after therapeutic radiation. Primary diagnoses were Hodgkin disease (n = 18 patients), non‐Hodgkin lymphoma (n = 10 patients), acute lymphoblastic leukemia (n = 2 patients), acute myeloid leukemia (n = 1 patient), Wilms tumor (n = 1 patient), and neuroblastoma (n = 1 patient). The median age at the time of diagnosis of the primary malignancy was 12.0 years (range, 3.7–18.3 years), the median radiation dose to the thyroid gland was 2400 centigrays (cGy; range, 1000–4200 cGy), and the median interval from the time of radiation therapy until the recognition of thyroid disease was 13.0 years (range, 6.2–30.1 years). Thirteen of 33 thyroid lesions (39%) were malignant (11 papillary carcinomas and 2 follicular carcinomas). Age at diagnosis, gender ratio, and time elapsed since initial treatment did not differ between patients with malignant and benign lesions, but the median radiation dose to the thyroid was lower in patients who had malignant disease compared with patients who had benign disease (2000 cGy vs. 2950 cGy; P = 0.03). Disease was confined to the neck in all patients who had malignant thyroid lesions; after a median follow‐up of 6.5 years (range, 0.9–12 years), none of the patients developed progressive or recurrent disease.CONCLUSIONSData from this study suggest that a high proportion of clinically apparent thyroid neoplasms that develop after therapeutic radiation for a childhood malignancy are malignant. However, most of these thyroid malignancies do not appear to behave in an aggressive fashion. Because thyroid neoplasms may not become evident for decades after radiation therapy, all individuals who are at risk require life‐long follow‐up. Cancer 2003;97:2397–403. © 2003 American Cancer Society.DOI 10.1002/cncr.11362

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“…At 30 years, the cumulative incidence in HL survivors is 4.4% [34]. Although the minimum latency period for secondary thyroid carcinoma is 5 years [34, 49, 50], the incidence of thyroid carcinoma remains increased beyond 40 years after irradiation for primary cancer [34, 51, 52]. Secondary thyroid cancer is more common in females, and young age at treatment is an independent risk factor [34].…”

Section: Overview Of Second Malignancy Risks After Selected Childhoodmentioning

confidence: 99%

Secondary Malignancies Across the Age Spectrum

Kenney

Gilbert

et al. 2010

Seminars in Radiation Oncology

119

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Development of a second malignancy is one of the most serious late effects in survivors of both childhood and adult-onset cancers. Patterns of second malignancy risk across the age spectrum can differ in terms of the types of second malignancies observed, magnitude of the risks, the latency period, associated risk factors, and modifying influences. Potential explanations for the varying risk patterns by age include differences in susceptibility of individual tissue/organ to carcinogenesis based on stage of development and level of tissue maturity, microenvironment, attained age, and lifestyle factors. A thorough understanding of these differences is essential when considering treatment modifications in newly diagnosed cancer patients that are aimed at reducing the risk of second malignancy and other late effects without compromising cure. Moreover, an understanding of the variations in second cancer risk according to age at treatment is important in customizing patient follow-up.

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Secondary thyroid carcinoma after treatment for childhood cancer

Cited by 61 publications

References 25 publications

Secondary thyroid carcinoma after allogeneic bone marrow transplantation during childhood

Secondary thyroid carcinoma after allogeneic bone marrow transplantation during childhood

Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

Secondary Malignancies Across the Age Spectrum

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