Second primary malignancies in thyroid cancer patients

By C. Rubino, F. Vathaire, M. Dottorini, P. Hall, C. Schvartz, J. Couette, Marie-Gabrielle Dondon, M. Abbas, C. Langlois, M. Schlumberger. British Journal of Cancer, 2003

631 citations recorded by the source corpus.

The late health effects associated with radioiodine (131I) given as treatment for thyroid cancer are difficult to assess since the number of thyroid cancer patients treated at each centre is limited. The risk of second primary malignancies (SPMs) was evaluated in a European cohort of thyroid cancer patients. A common database was obtained by pooling the 2-year survivors of the three major Swedish, Italian, and French cohorts of papillary and follicular thyroid cancer patients. A time-dependent analysis using external comparison was performed. The study concerned 6841 thyroid cancer patients, diagnosed during the period 1934–1995, at a mean age of 44 years. In all, 17% were treated with external radiotherapy and 62% received 131I. In total, 576 patients were diagnosed with a SPM. Compared to the general population of each of the three countries, an overall significantly increased risk of SPM of 27% (95% CI: 15–40) was seen in the European cohort. An increased risk of both solid tumours and leukaemias was found with increasing cumulative activity of 131I administered, with an excess absolute risk of 14.4 solid cancers and of 0.8 leukaemias per GBq of 131I and 105 person-years of follow-up. A relationship was found between 131I administration and occurrence of bone and soft tissue, colorectal, and salivary gland cancers. These results strongly highlight the necessity to delineate the indications of 131I treatment in thyroid cancer patients in order to restrict its use to patients in whom clinical benefits are expected.

Subfields: Endocrinology, Diabetes and Metabolism, Genetics, Radiology, Nuclear Medicine and Imaging

View Paper: https://www.semanticscholar.org/paper/22adb99b05a84e36484ec24cea24a84720a01cc1

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

1. M. Schlumberger
2. M. Luster
3. G. Francis
4. C. Durante
5. S. Waguespack
6. D. Hartl
7. A. Bauer
8. S. Leboulleux

Citations in the corpus

• 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer (2009, neutral): “cancer patients has been recognized after the administration of high cumulative activities of (131)I (762,763), this elevated risk was not found to be associated with the use of (131)I in another study (764).”
• Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer (2009, neutral): “While RAI appears to be a reasonably safe therapy, it is associated with a cumulative dose-related low risk of earlyand late-onset complications such as salivary gland damage, dental caries (397), nasolacrimal duct obstruction (398), and secondary malignancies (157,281,399,400).”
• Guidelines for radioiodine therapy of differentiated thyroid cancer (2008, neutral): “[112–114] Limit RAIT above these cumulative”
• Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer (2015, background): “A few studies combining patients of all ages have shown that (131)I therapy is associated with an increased risk for second malignancies and an increase in overall mortality for patients with DTC (7).”
• Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce (2006, neutral): “The risk of secondary malignancies is dose-related (267).”
• Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. (2006, background): “We recently reported that cumulative activities of (131)I larger than 22 GBq (600 mCi) are associated with an increased risk of cancer and leukemia (16).”