Post-surgical ablation of thyroid residues with radioiodine in Ukrainian children and adolescents affected by post-Chernobyl differentiated thyroid cancer.

摘要

Post-surgical ablation of thyroid residues with 131-iodine (131-I) is usually recommended after near-total thyroidectomy in high-risk patients, including children, with differentiated thyroid cancer (DTC). We report here the results of post-surgical radioiodine thyroid ablation in 249 children and adolescents of Ukraine with post-Chernobyl DTC initially treated with near-total thyroidectomy at the Institute of Endocrinology and Metabolism in Kiev, during a 2-year period. The patients' age at the time of the Chernobyl accident (1986), ranged from <1 to 14 yr in 223 subjects (children) and from 15 to 18 yr in 26 subjects (adolescents). Six weeks after surgery a diagnostic 131-I whole body scan revealed the presence of residual thyroid tissue in all cases. All patients received one or more courses of radioiodine therapy, for a total of 468 courses. One hundred and twenty-nine out of 249 patients (51.8) were successfully ablated. The total number of treatment courses needed in these patients was 219. Most patients required multiple doses of radioiodine, only 63 required a single dose. One hundred and twenty patients (48.2) treated with radioiodine were not ablated and are still under treatment program. The clinical features and the amount of thyroid residue were not different in ablated or not-ablated patients. Our results indicate that in this particular population of post-Chernobyl thyroid carcinomas, thyroid ablation is a rather difficult task. Only 51.8 were successfully ablated. Possible explanation for this finding may be the young age of the patients, other particular features of post-Chernobyl thyroid carcinoma or technical aspects, such as less radical surgical procedures.