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Is radioactive iodine- ( 131 ) treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?
OBJECTIVE: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Endocrinologia e Metabologia
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118921/ https://www.ncbi.nlm.nih.gov/pubmed/26222230 http://dx.doi.org/10.1590/2359-3997000000078 |
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author | de Souza, Marcelo Cruzick Momesso, Denise P. Vaisman, Fernanda Vieira, Leonardo Martins, Rosangela Aparecida Gomes Corbo, Rossana Vaisman, Mario |
author_facet | de Souza, Marcelo Cruzick Momesso, Denise P. Vaisman, Fernanda Vieira, Leonardo Martins, Rosangela Aparecida Gomes Corbo, Rossana Vaisman, Mario |
author_sort | de Souza, Marcelo Cruzick |
collection | PubMed |
description | OBJECTIVE: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. MATERIALS AND METHODS: Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. RESULTS: During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs. 0.87; p = 0.06), what was not affected by age at DTC diagnosis. CONCLUSION: In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors. |
format | Online Article Text |
id | pubmed-10118921 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Sociedade Brasileira de Endocrinologia e Metabologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-101189212023-04-21 Is radioactive iodine- ( 131 ) treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer? de Souza, Marcelo Cruzick Momesso, Denise P. Vaisman, Fernanda Vieira, Leonardo Martins, Rosangela Aparecida Gomes Corbo, Rossana Vaisman, Mario Arch Endocrinol Metab Original Article OBJECTIVE: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. MATERIALS AND METHODS: Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. RESULTS: During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs. 0.87; p = 0.06), what was not affected by age at DTC diagnosis. CONCLUSION: In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors. Sociedade Brasileira de Endocrinologia e Metabologia 2015-07-01 /pmc/articles/PMC10118921/ /pubmed/26222230 http://dx.doi.org/10.1590/2359-3997000000078 Text en https://creativecommons.org/licenses/by-nc/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article de Souza, Marcelo Cruzick Momesso, Denise P. Vaisman, Fernanda Vieira, Leonardo Martins, Rosangela Aparecida Gomes Corbo, Rossana Vaisman, Mario Is radioactive iodine- ( 131 ) treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer? |
title |
Is radioactive iodine-
(
131
)
treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?
|
title_full |
Is radioactive iodine-
(
131
)
treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?
|
title_fullStr |
Is radioactive iodine-
(
131
)
treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?
|
title_full_unstemmed |
Is radioactive iodine-
(
131
)
treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?
|
title_short |
Is radioactive iodine-
(
131
)
treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?
|
title_sort | is radioactive iodine-
(
131
)
treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118921/ https://www.ncbi.nlm.nih.gov/pubmed/26222230 http://dx.doi.org/10.1590/2359-3997000000078 |
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