BACKGROUND: The thyroid gland is among the most radiosensitive organs. However, little is known about the long-term risk of developing a thyroid tumor after fractionated external radiotherapy for cancer during childhood. OBJECTIVE: To study the long-term risk of developing a thyroid tumor in 4096 three-year survivors of childhood cancer treated between May 1942 and December 1985 in 8 centers in France and the United Kingdom, 2827 of whom had received external radiotherapy. METHODS: A wide range of radiation doses were given to the thyroid: 1164 children received less than 0.5 Gy and 812 received more than 5.0 Gy, the average dose being 7.0 Gy. RESULTS: After mean follow-up of 15 years (range, 3-45 years), 14 patients-all of whom had received radiotherapy-developed a clinical thyroid carcinoma. Within the cohort, the relation between radiation dose to the thyroid and risk of thyroid carcinoma and adenoma was similar to that observed in patients who received radiotherapy during childhood for other reasons, such as an excess relative risk per gray of 4 to 8, up to a few gray. In contrast, compared with thyroid cancer incidence in the general population, the standardized incidence of thyroid carcinoma was much higher than expected from the dose-response relationship estimated within the cohort and from patients who received radiotherapy during childhood for other reasons: a dose of 0.5 Gy was associated with a standardized incidence ratio of 35 (90% confidence interval, 10-87) and a dose of 3.6 Gy with a standardized incidence ratio of 73 (90% confidence interval, 28-153). We did not show a reduction in excess relative risk per gray with use of an increasing number of fractions. CONCLUSION: Although we cannot estimate the exact proportion, it is probable that some or all children who are treated for cancer are predisposed to developing a thyroid carcinoma.
BACKGROUND: The thyroid gland is among the most radiosensitive organs. However, little is known about the long-term risk of developing a thyroid tumor after fractionated external radiotherapy for cancer during childhood. OBJECTIVE: To study the long-term risk of developing a thyroid tumor in 4096 three-year survivors of childhood cancer treated between May 1942 and December 1985 in 8 centers in France and the United Kingdom, 2827 of whom had received external radiotherapy. METHODS: A wide range of radiation doses were given to the thyroid: 1164 children received less than 0.5 Gy and 812 received more than 5.0 Gy, the average dose being 7.0 Gy. RESULTS: After mean follow-up of 15 years (range, 3-45 years), 14 patients-all of whom had received radiotherapy-developed a clinical thyroid carcinoma. Within the cohort, the relation between radiation dose to the thyroid and risk of thyroid carcinoma and adenoma was similar to that observed in patients who received radiotherapy during childhood for other reasons, such as an excess relative risk per gray of 4 to 8, up to a few gray. In contrast, compared with thyroid cancer incidence in the general population, the standardized incidence of thyroid carcinoma was much higher than expected from the dose-response relationship estimated within the cohort and from patients who received radiotherapy during childhood for other reasons: a dose of 0.5 Gy was associated with a standardized incidence ratio of 35 (90% confidence interval, 10-87) and a dose of 3.6 Gy with a standardized incidence ratio of 73 (90% confidence interval, 28-153). We did not show a reduction in excess relative risk per gray with use of an increasing number of fractions. CONCLUSION: Although we cannot estimate the exact proportion, it is probable that some or all children who are treated for cancer are predisposed to developing a thyroid carcinoma.
Authors: Parveen Bhatti; Lene H S Veiga; Cécile M Ronckers; Alice J Sigurdson; Marilyn Stovall; Susan A Smith; Rita Weathers; Wendy Leisenring; Ann C Mertens; Sue Hammond; Debra L Friedman; Joseph P Neglia; Anna T Meadows; Sarah S Donaldson; Charles A Sklar; Leslie L Robison; Peter D Inskip Journal: Radiat Res Date: 2010-10-06 Impact factor: 2.841
Authors: Stephanie A Kovalchik; Cécile M Ronckers; Lene H S Veiga; Alice J Sigurdson; Peter D Inskip; Florent de Vathaire; Charles A Sklar; Sarah S Donaldson; Harald Anderson; Parveen Bhatti; Sue Hammond; Wendy M Leisenring; Ann C Mertens; Susan A Smith; Marilyn Stovall; Margaret A Tucker; Rita E Weathers; Leslie L Robison; Ruth M Pfeiffer Journal: J Clin Oncol Date: 2012-11-19 Impact factor: 44.544
Authors: Stephen P Finn; Paul Smyth; Esther O'regan; Susanne Cahill; Richard Flavin; John O'leary; Orla Sheils Journal: Virchows Arch Date: 2004-07-17 Impact factor: 4.064
Authors: Lene H S Veiga; Erik Holmberg; Harald Anderson; Linda Pottern; Siegal Sadetzki; M Jacob Adams; Ritsu Sakata; Arthur B Schneider; Peter Inskip; Parveen Bhatti; Robert Johansson; Gila Neta; Roy Shore; Florent de Vathaire; Lena Damber; Ruth Kleinerman; Michael M Hawkins; Margaret Tucker; Marie Lundell; Jay H Lubin Journal: Radiat Res Date: 2016-04-29 Impact factor: 2.841