"Radioactive iodine therapy in low-risk pediatric thyroid cancer: universal standard or selective indication?"

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2025-05-23 DOI:10.1007/s12020-025-04284-x

Gerdi Tuli, Jessica Munarin, Luisa De Sanctis

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引用次数: 0

Abstract

Radioactive iodine (RAI) treatment in low-risk pediatric patients with differentiated thyroid cancer (DTC) is still debatable. The objective of this study is to evaluate the outcome of treated and untreated patients in pediatric age. The data of all pediatric patients affected by low-risk category DTC according to ATA (American Thyroid Association) during the period 2010-2024 were reviewed. Patients with DTC dimensions > 2 cm and/or lymph node involvement underwent to RAI. In our cohort 7/14 (50%) of subjects were treated with RAI. Cytological categories after FNAB were TIR3b in 2/7 (28.6%) and TIR5 in 5/7 (71.4%) for RAI-treated patients, whereas TIR3b was observed in 6/7 (85.7%) and TIR5 in 1/7 (14.3%) in untreated patients (p = 0.03). T1 stage was assigned in 1/7 (14.3%) of patient treated with RAI, T2 stage was present in the remaining 6/7 (85.7%), whereas T 1 stage was observed in 6/7 (85.7%) and T2 stage in 1/7 (14.3%) of untreated patients (p = 0.007). No difference was observed regarding disease persistence or recurrence between treated and untreated patients. Considering the young age, a case-by-case approach may be reasonable in subjects assigned to the low-risk category, rather than absolute recommendation for all pediatric patients with DTC.

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放射性碘治疗低危儿童甲状腺癌：通用标准还是选择性指征？

放射性碘（RAI）治疗低危儿童分化型甲状腺癌（DTC）仍有争议。本研究的目的是评估治疗和未治疗的儿童年龄患者的预后。根据ATA（美国甲状腺协会）2010-2024年期间所有低风险类DTC患儿的数据进行了回顾。DTC尺寸为bb0 ~ 2cm和/或淋巴结受累的患者行RAI。在我们的队列中，7/14（50%）的受试者接受了RAI治疗。接受raib治疗的患者FNAB后的细胞学分类为2/7 (28.6%)TIR3b和5/7(71.4%)，而未接受raib治疗的患者FNAB后的细胞学分类为6/7 (85.7%)TIR3b和1/7 (14.3%)TIR5。RAI治疗组1/7（14.3%）为T1期，其余6/7（85.7%）为T2期，未治疗组6/7（85.7%）为T1期，未治疗组1/7（14.3%）为T2期（p = 0.007）。在接受治疗和未接受治疗的患者之间，没有观察到疾病持续或复发的差异。考虑到儿童年龄小，对低风险类别的受试者采用具体情况具体分析的方法可能是合理的，而不是绝对推荐给所有患有DTC的儿科患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.