{"title":"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？","authors":"Gerdi Tuli, Jessica Munarin, Luisa De Sanctis","doi":"10.1007/s12020-025-04284-x","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"\\\"Radioactive iodine therapy in low-risk pediatric thyroid cancer: universal standard or selective indication?\\\"\",\"authors\":\"Gerdi Tuli, Jessica Munarin, Luisa De Sanctis\",\"doi\":\"10.1007/s12020-025-04284-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":11572,\"journal\":{\"name\":\"Endocrine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-05-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12020-025-04284-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12020-025-04284-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
"Radioactive iodine therapy in low-risk pediatric thyroid cancer: universal standard or selective indication?"
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.
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.
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