Instituto Nacional de Câncer Departamento de Endocrinologia Oncológica Rio de JaneiroRJ Brasil Departamento de Endocrinologia Oncológica, Instituto Nacional de Câncer (Inca), Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro Faculdade de Medicina Departamento de Endocrinologia Rio de JaneiroRJ Brasil Departamento de Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
Arch Endocrinol Metab. 2024 Oct 4;68:e230505. doi: 10.20945/2359-4292-2023-0505. eCollection 2024.
Patients with pediatric differentiated thyroid carcinoma (DTC) treated with radioiodine (RAI) therapy may experience long-term side effects, such as gonadal dysfunction. Therefore, it is crucial to understand the impact of this therapy on ovarian reserve and future pregnancy rates.
Retrospective analysis of 64 female DTC survivors of childbearing age to assess the risk of infertility due to RAI performed before the age of 19 years.
Thirty-two out of the 64 DTC survivors had a history of at least one pregnancy during follow-up. No significant differences were observed between the cumulative RAI activity, treatment regimens (multiple versus single RAI treatment), age at first treatment, or presence of lymph node or distant metastases. Notably, the group without a history of pregnancy had a younger age at the time of diagnosis and larger tumors. Age at first pregnancy was slightly higher than that in the general population, but no increase in negative maternal or fetal outcomes was observed.
The results of this study show little observational evidence suggesting important adverse effects of RAI on fertility or pregnancy outcomes among female survivors of childhood DTC. Still, studies including larger populations are warranted.
接受放射性碘(RAI)治疗的儿童分化型甲状腺癌(DTC)患者可能会出现长期副作用,如性腺功能障碍。因此,了解这种治疗对卵巢储备和未来妊娠率的影响至关重要。
对 64 名处于生育年龄的女性 DTC 幸存者进行回顾性分析,以评估 19 岁之前接受 RAI 治疗导致不孕的风险。
64 名 DTC 幸存者中有 32 名在随访期间至少有一次妊娠史。累积 RAI 活性、治疗方案(多次与单次 RAI 治疗)、首次治疗时的年龄或淋巴结或远处转移的存在,均无显著差异。值得注意的是,无妊娠史的组在诊断时年龄较小,肿瘤较大。首次妊娠年龄略高于一般人群,但未观察到母婴不良结局增加。
本研究结果表明,RAI 对儿童期 DTC 女性幸存者的生育能力或妊娠结局几乎没有观察到重要的不良影响。但仍需要更大人群的研究。