Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

Acharya, Suchitra; Sarafoglou, Kyriakie; LaQuaglia, Michael J.; Lindsley, Skyler K.; Gerald, William L.; Wollner, Norma; Tan, Charlotte; Sklar, Charles A.

doi:10.1002/cncr.11362

Cited by 172 publications

(92 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This subtype is the most frequent one, not only in the general population, but also following treatment for childhood malignancy. 11,13,37,38,40,41 Some authors found that being less than 10 years of age was associated with an increased risk of thyroid cancer, 11,13,38 although we did not find similar results. In contrast, we confirmed that women are at an increased risk of developing thyroid cancer (HR=4.74; P=0.002), which has been suggested by other studies 13 and observed in the general population.…”

Section: Discussioncontrasting

confidence: 95%

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Oudin¹,

Auquier²,

Bertrand³

et al. 2016

Haematologica

View full text Add to dashboard Cite

T hyroid complications are known side effects of irradiation. However, the risk of such complications in childhood acute leukemia survivors who received either central nervous system irradiation or hematopoietic stem cell transplantation is less described. We prospectively evaluated the incidence and risk factors for thyroid dysfunction and tumors in survivors of childhood acute myeloid or lymphoid leukemia. A total of 588 patients were evaluated for thyroid function, and 502 individuals were assessed for thyroid tumors (median follow-up duration: 12.6 and 12.5 years, respectively). The cumulative incidence of hypothyroidism was 17.3% (95% CI: 14.1-21.1) and 24.6% (95% CI: 20.4-29.6) at 10 and 20 years from leukemia diagnosis, respectively. Patients who received total body irradiation (with or without prior central nervous system irradiation) were at higher risk of hypothyroidism (adjusted HR: 2.87; P=0.04 and 2.79, P=0.01, respectively) as compared with transplanted patients who never received any irradiation. Patients transplanted without total body irradiation who received central nervous system irradiation were also at higher risk (adjusted HR: 3.39; P=0.02). Patients irradiated or transplanted at older than 10 years of age had a lower risk (adjusted HR: 0.61; P=0.02). Thyroid malignancy was found in 26 patients (5.2%). Among them, two patients had never received any type of irradiation: alkylating agents could also promote thyroid cancer. The cumulative incidence of thyroid malignancy was 9.6% (95% CI: 6.0-15.0) at 20 years. Women were at higher risk than men (adjusted HR: 4.74; P=0.002). In conclusion, thyroid complications are frequent among patients who undergo transplantation after total body irradiation and those who received prior central nervous system irradiation. Close monitoring is thus warranted for these patients.

show abstract

Section: Discussioncontrasting

confidence: 95%

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Oudin¹,

Auquier²,

Bertrand³

et al. 2016

Haematologica

View full text Add to dashboard Cite

show abstract

“…A distinctive finding was the high frequency of multicentricity, but the baseline and treatment factors related to recurrence were very similar to those for thyroid cancer patients in the general population. Based on this and the findings of others we recommended that patients with radiationrelated thyroid cancer should be treated in the same way as unexposed patients with thyroid cancer (2)(3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 70%

Clinical Behavior of Radiation-Induced Thyroid Cancer: Factors Related to Recurrence

Naing

Collins

Schneider

2009

Thyroid

View full text Add to dashboard Cite

Background: Whether thyroid cancer is more aggressive in radiation-exposed patients is not resolved. The frequency of aggressive features in post-Chernobyl patients suggests this may be the case. Our aim was to address this question by re-examining the pattern of risk factors for recurrence of thyroid cancers found in a cohort exposed to external radiation. Methods: The study population was drawn from a cohort of 4296 people, followed since 1974, who were treated before the age of 16 with conventional external radiation for benign conditions of the head and neck between 1939 and the early 1960s. The study group consisted of 390 patients who had surgically verified thyroid cancer. Potential risk factors for recurrence were evaluated by proportional hazards analysis. Results: Fifty patients had recurrences an average of 8.7 years after diagnosis while the other 340 patients were followed for an average of 19.7 years. The sooner after radiation exposure the cancer occurred, the more likely it was to recur (hazard ratio, 0.96=year; 95% confidence interval [CI] 0.91-0.99). Taking into account the effect of the onset of screening in 1974, the features predictive of recurrence were younger age at the initial diagnosis (hazard ratio, 0.95=year; 95% CI, 0.91-0.99) and the size of the thyroid cancer (hazard ratio, 1.2=cm; 95% CI, 1.0-1.6). Conclusion:Although not based on a direct comparison, we conclude that thyroid cancers following external radiation exposure are not, on average, more aggressive than other thyroid cancers. The similarity of risk factors for recurrence suggests that they should be treated and followed in the same way as non-radiation-induced thyroid cancers.

show abstract

“…The nodules were bilateral in eight (38%) of the 21 patients. Nodule diameter ranged from 6 to 40 mm, with a median value of 13.7 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) mm.…”

Section: Ultrasound Findingsmentioning

confidence: 99%

“…Studies on patients receiving irradiation treatment for various cancers have reported a high frequency of benign and malignant thyroid nodules. The reported relative risks for thyroid nodules among the survivors of pediatric cancers who have undergone radiation therapy vary greatly, with an incidence of malignancy of 10-40% (6,7,8,9,10,11,12,13). Analysis of studies evaluating thyroid carcinoma after exposure to external radiation during childhood showed that the dose-response relationship was linear, although the risk appeared to plateau at the highest dose, with risk appearing to slightly decrease at doses of even more than 2000 cGy (9,11,13,14,15,16).…”

Section: Introductionmentioning

confidence: 99%

Malignant and benign thyroid nodules after total body irradiation preceding hematopoietic cell transplantation during childhood

Vivanco

Dalle²,

Alberti³

et al. 2012

European Journal of Endocrinology

View full text Add to dashboard Cite

Background: The risk of radiation-induced benign and malignant thyroid nodules is well known. Objective: The aim of this study was to determine the occurrence of thyroid nodules and carcinomas after fractionated total body irradiation (TBI) preceding hematopoietic stem cell transplantation (HSCT) for malignant hematological disease during childhood. Methods: We conducted a retrospective university hospital-based observational study. The participants were 76 patients receiving fractionated TBI between 1989 and 2009 as part of the conditioning regimen for HSCT to treat malignant hematological disease, with a median age of 8.2 (5.7-11.4) years, for whom the last ultrasound examination was performed at a median age of 14.2 (11.2-17) years. The main outcome measure was cumulative incidence of thyroid nodules detected by ultrasound scans followed by biopsy if necessary. Results: Thyroid nodules were examined in 21 (28%) patients, six (29%) of whom were diagnosed with thyroid carcinoma at the age of 2.2-18.6 years after TBI. The cumulative incidence of nodule occurrence increased with increasing time from diagnosis. The 10-year cumulative incidence of benign and malignant thyroid nodules was 16% (95% confidence interval (CI) 4-27%) and 8% (95% CI 0-16%) respectively. Seventeen (22%) patients had hypothyroidism (compensated nZ12, in five patients it was transient). No significant independent risk factors were identified in the multivariable competing risk model as a function of nodule occurrence. Conclusion: Short-term and life-long monitoring, with screening for nodules of the thyroid gland using ultrasound scans, is recommended for survivors subjected to TBI for HSCT during childhood.

show abstract

Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

Cited by 172 publications

References 37 publications

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Clinical Behavior of Radiation-Induced Thyroid Cancer: Factors Related to Recurrence

Malignant and benign thyroid nodules after total body irradiation preceding hematopoietic cell transplantation during childhood

Contact Info

Product

Resources

About