Tsinopoulou Vasiliki Rengina, Kotanidou Eleni P, Kolanis Savvas, Tragiannidis Athanasios, Hatzipantelis Emmanouel, Galli-Tsinopoulou Assimina
2nd Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece.
J Clin Med. 2025 Jun 14;14(12):4248. doi: 10.3390/jcm14124248.
Radiotherapy for leukemia, the most common childhood malignancy, often exposes patients to radiation, increasing the risk of second malignancies, including thyroid cancer. To assess the incidence and survival outcomes of thyroid cancer after childhood acute lymphoblastic leukemia (ALL). : We systematically reviewed articles reporting the incidence of thyroid cancer in childhood leukemia survivors (age at diagnosis < 18 years) published between 2000-2024 in Science Direct, PubMed, Google Scholar, CENTRAL, and EMBASE. The Newcastle Ottawa Scale was utilized to appraise the methodological quality of the included studies. Descriptive statistics and calculations of incidence were performed using Microsoft Excel. : The literature search yielded 1265 articles, of which 18 met the inclusion criteria. Data from 135,861 childhood cancer survivors, among whom 102,070 had a confirmed diagnosis of childhood leukemia, including ALL. The crude incidence of secondary malignancies after childhood leukemia was 10.1 per 1000 patients. Among these, 1.5 per 1000 patients developed second thyroid carcinomas. Overall, 14.6% of the second malignancies in childhood leukemia survivors were thyroid carcinomas, mostly of the papillary type. Survival rates after second thyroid cancer were 100% in all 11/18 studies reporting this outcome. Radiotherapy had been used as part of ALL treatments in 17/18 studies. The use of radiotherapy, female sex, and younger age at the diagnosis of primary ALL emerged as important risk factors for thyroid cancer. : Thyroid carcinomas account for ~15% of secondary malignancies after childhood leukemia, with radiation remaining a significant risk factor despite its overall reduced use for the treatment of ALL in the last few decades. Importantly, survival rates remain high. Further research is warranted to determine the incidence and outcomes of thyroid cancer in childhood ALL survivors.
白血病是儿童期最常见的恶性肿瘤，放射治疗常常使患者暴露于辐射之下，增加了包括甲状腺癌在内的二次恶性肿瘤的风险。为评估儿童急性淋巴细胞白血病（ALL）后甲状腺癌的发病率和生存结果。：我们系统回顾了2000年至2024年期间发表在《科学Direct》《PubMed》《谷歌学术》《CENTRAL》和《EMBASE》上的关于儿童白血病幸存者（诊断时年龄<18岁）甲状腺癌发病率的文章。采用纽卡斯尔渥太华量表评估纳入研究的方法学质量。使用微软Excel进行描述性统计和发病率计算。：文献检索共获得1265篇文章，其中18篇符合纳入标准。来自135861名儿童癌症幸存者的数据，其中102070名确诊为儿童白血病，包括ALL。儿童白血病后二次恶性肿瘤的粗发病率为每1000例患者10.1例。其中，每1000例患者中有1.5例发生继发性甲状腺癌。总体而言，儿童白血病幸存者中14.6%的二次恶性肿瘤为甲状腺癌，大多为乳头状类型。在所有18项报告该结果的研究中，11项研究显示继发性甲状腺癌后的生存率为100%。18项研究中有17项将放射治疗用作ALL治疗的一部分。放射治疗的使用、女性性别以及原发性ALL诊断时年龄较小是甲状腺癌的重要危险因素。：甲状腺癌约占儿童白血病后二次恶性肿瘤的15%，尽管在过去几十年中放射治疗在ALL治疗中的总体使用有所减少，但仍是一个重要的危险因素。重要地是，生存率仍然很高。有必要进一步研究以确定儿童ALL幸存者中甲状腺癌的发病率和结果。
