Favourable course of disease after incomplete remission on (131)I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up.

摘要

PURPOSE: The aim of this study is to report on a collective of 20 children from Belarus who had developed papillary thyroid carcinoma with pulmonary metastases after the Chernobyl disaster. In all children fractionated radioiodine therapy (RIT) was ceased before achieving complete remission due to a lack of further effects of (131)I therapy and an increased risk of pulmonary fibrosis. METHODS: The 20 children (12 girls) were treated with (131)I using 50 MBq/kg body weight for thyroid remnant ablation and 100 MBq/kg for further therapy in intervals of 5-12 months. After five to six courses and a cumulative activity of about 24 GBq (131)I no further RIT was conducted; the median thyroglobulin (TG) was 56 mug/l at this time. All patients were followed for at least 10 years after cessation of RIT using diagnostic whole-body scintigraphy, CT of the chest, lung function testing and stimulated TG measurements every 1-3 years. RESULTS: During follow-up after the last RIT a continuous decline of values for TG levels of approximately 35% per year was observed between individual visits. The median Tg level at the time of cessation of (131)I therapy was 56 microg/l; however, at the last visit 16 of 20 patients had a TG level