Tamam Muge, Uyanik Ercan, Edís Nurcan, Mulazimoglu Mehmet, Ozpacaci Tevfik
Department of Nuclear Medicine, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey.
World J Nucl Med. 2019 Nov 6;19(1):28-35. doi: 10.4103/wjnm.WJNM_15_19. eCollection 2020 Jan-Mar.
Differentiated thyroid cancer (DTC) is rare in children, but it still remains the most common endocrine malignancy in children. The aim of this study was to analyze treatment response to radioactive iodine (RAI) therapy, clinical outcomes, recurrences, survival analysis, and long-term follow-up. We retrospectively reviewed the medical records of 43 pediatric patients (≤17 years of age) with DTC diagnosis after thyroidectomy who were treated with RAI. The follow-up protocol consisted of detailed clinical examination, testing of thyroid function, determination of serum thyroglobulin (Tg), and anti-Tg antibodies, and neck ultrasonography application. Forty-three pediatric patients (34 females and 9 males) treated with RAI for DTC in our institute. The median follow-up period was 54 months. The histologic classification was papillary thyroid cancer in 41 patients and the remaining 2 patients had follicular thyroid cancer. After the long-term follow-up, complete remission, partial remission, and recurrent-persistent disease were observed in 37 patients, 3 patients, and 3 patients, respectively. Among the series, 1 death occurred due to multiple metastases. The mortality rate is 2.56%. Total thyroidectomy followed by RAI appears to be the most effective treatment for patients with pediatric DTC in terms of reducing the rate of relapse and improving surveillance for recurrent disease.
分化型甲状腺癌(DTC)在儿童中较为罕见,但仍是儿童最常见的内分泌恶性肿瘤。本研究旨在分析放射性碘(RAI)治疗的反应、临床结局、复发情况、生存分析及长期随访结果。我们回顾性分析了43例甲状腺切除术后诊断为DTC并接受RAI治疗的儿科患者(≤17岁)的病历。随访方案包括详细的临床检查、甲状腺功能检测、血清甲状腺球蛋白(Tg)及抗Tg抗体测定,以及颈部超声检查。我院43例儿科患者(34例女性,9例男性)接受了DTC的RAI治疗。中位随访期为54个月。组织学分类中,41例为乳头状甲状腺癌,其余2例为滤泡状甲状腺癌。经过长期随访,分别有37例、3例和3例患者出现完全缓解、部分缓解和复发持续性疾病。该系列中有1例因多发转移死亡。死亡率为2.56%。甲状腺全切术联合RAI似乎是降低儿科DTC患者复发率及改善复发疾病监测的最有效治疗方法。