Chow Sin-Ming, Law Stephen C K, Mendenhall William M, Au Siu-Kie, Yau Stephen, Mang Oscar, Lau Wai-Hon
Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China.
Pediatr Blood Cancer. 2004 Feb;42(2):176-83. doi: 10.1002/pbc.10410.
Differentiated thyroid carcinoma (DTC) in childhood has a good prognosis despite a high incidence of relapse. The use of radioactive iodine (RAI) has not been well established.
This is a review of 60 patients less than 21 years of age; mean follow-up was 14 years.
Patients had a higher relapse rate with papillary thyroid carcinoma (PTC) than with follicular thyroid carcinoma (FTC): 24.5 vs. 9.1%. Compared with 997 patients with age > or = 21, patients <21 years of age had a higher female to male ratio (7.6 vs. 3.9), higher incidence of nodal metastasis (45 vs. 28%), and lung metastasis (15 vs. 7.8%), and improved 10-year cause-specific survival (CSS) (98.3 vs. 89.5%). The 10-year rates of CSS, local-regional failure-free survival (LRFFS), and distant metastasis failure-free survival (DMFFS) for the young patients were 98.3, 79.3, and 90.7%, respectively. In patients with no distant metastasis at presentation, RAI improved 10-year LRFFS (71.9 vs. 86.5%; P = 0.04). At last follow-up, 10 of 12 patients (80%) with local-regional (LR) relapse and five of nine patients (55.6%) with distant metastasis were rendered disease-free. No patient has experienced a second malignancy.
Prognosis of DTC in young patients was good. Patients with LR relapse and distant metastasis had a high rate of remission after treatment. RAI treatment can reduce the rate of LR relapse in patients with no distant metastasis and result in complete remission in half of those with distant metastasis. No patient experienced a second malignancy.
儿童分化型甲状腺癌（DTC）尽管复发率高，但预后良好。放射性碘（RAI）的使用尚未得到充分确立。
回顾了60例年龄小于21岁的患者；平均随访14年。
甲状腺乳头状癌（PTC）患者的复发率高于滤泡状甲状腺癌（FTC）：分别为24.5%和9.1%。与997例年龄≥21岁的患者相比，年龄＜21岁的患者男女比例更高（7.6比3.9），淋巴结转移发生率更高（45%比28%），肺转移发生率更高（15%比7.8%），且10年病因特异性生存率（CSS）更高（98.3%比89.5%）。年轻患者的10年CSS、局部区域无病生存率（LRFFS）和远处转移无病生存率（DMFFS）分别为98.3%、79.3%和90.7%。在初诊时无远处转移的患者中，RAI提高了10年LRFFS（71.9%比86.5%；P = 0.04）。在最后一次随访时，12例局部区域（LR）复发患者中有10例（80%）和9例远处转移患者中有5例（55.6%）实现了疾病缓解。没有患者发生第二原发恶性肿瘤。
年轻患者DTC的预后良好。LR复发和远处转移的患者治疗后缓解率高。RAI治疗可降低无远处转移患者的LR复发率，并使一半的远处转移患者完全缓解。没有患者发生第二原发恶性肿瘤。
