Second primary malignancies in thyroid cancer patients

被引:427
作者
Rubino, C
de Vathaire, F
Dottorini, ME
Hall, P
Schvartz, C
Couette, JE
Dondon, MG
Abbas, MT
Langlois, C
Schlumberger, M
机构
[1] Inst Gustave Roussy, INSERM, Unite XUR521, F-94805 Villejuif, France
[2] Osped Civile Legnano, Dept Nucl Med, I-20025 Legnano, Mi, Italy
[3] Karolinska Inst, Dept Med Epidemiol, S-17177 Stockholm, Sweden
[4] Inst Jean Godinoi, Dept Nucl Med, F-51056 Reims, France
[5] Francois Baclesse Inst, Dept Nucl Med, F-14076 Caen, France
[6] Inst Gustave Roussy, Dept Nucl Med, F-94805 Villejuif, France
关键词
second primary malignancies; thyroid cancer; leukaemia; colorectal cancer; radioiodine; pooled analysis;
D O I
10.1038/sj.bjc.6601319
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The late health effects associated with radioiodine (I-131) 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 I-131. 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 I-131 administered, with an excess absolute risk of 14.4 solid cancers and of 0.8 leukaemias per GBq of I-131 and 10(5) person-years of follow-up. A relationship was found between I-131 administration and occurrence of bone and soft tissue, colorectal, and salivary gland cancers. These results strongly highlight the necessity to delineate the indications of I-131 treatment in thyroid cancer patients in order to restrict its use to patients in whom clinical benefits are expected.
引用
收藏
页码:1638 / 1644
页数:7
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