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Published in: European Journal of Nuclear Medicine and Molecular Imaging 9/2011

01-09-2011 | Original Article

Pulmonary fibrosis in youth treated with radioiodine for juvenile thyroid cancer and lung metastases after Chernobyl

Authors: Helge Hebestreit, Johannes Biko, Valentina Drozd, Yuri Demidchik, Antje Burkhardt, Andreas Trusen, Meinrad Beer, Christoph Reiners

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2011

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Abstract

Purpose

The objective of this project was to systematically determine the prevalence and consequences of pulmonary fibrosis in youth with thyroid carcinoma and lung metastases from Belarus who were treated with radioiodine (131I).

Methods

A total of 69 patients treated for juvenile thyroid carcinoma and lung metastasis with 131I were assessed. A group of 29 patients without lung metastases and prior 131I treatment served as controls. The assessments included a CT scan of the lungs, extensive pulmonary function testing and an incremental cycle test to volitional fatigue with measurements of oxygen uptake (\( {\mathop {\text{V}}\limits^ \cdot } \)O2), oxygen saturation and alveolar-arterial difference in oxygen partial pressure (ΔaaO2).

Results

Five patients with lung metastases showed advanced pulmonary fibrosis on CT scans and also had poorer lung functions compared with the 62 patients with none or minor signs of fibrosis and the 29 controls. Furthermore, these five patients showed lower peak \( {\mathop {\text{V}}\limits^ \cdot } \)O2, lower oxygen saturation at peak exercise and higher exercise ΔaaO2. They were younger at the time of cancer diagnosis and had received chemotherapy more frequently than youth with pulmonary metastases who did not develop fibrosis. One of the five patients subsequently died from pulmonary fibrosis.

Conclusion

Following the Chernobyl catastrophe, about 7% of children treated with radioiodine for thyroid carcinoma and lung metastases displayed pulmonary fibrosis which was associated with functional impairments. Based on the characteristics of affected individuals, the number of radioiodine courses may have to be limited, especially in young children, and chemotherapy should be avoided.
Literature
1.
go back to reference Luster M, Lassmann M, Freudenberg LS, Reiners C. Thyroid cancer in childhood: management strategy, including dosimetry and long-term results. Hormones 2007;6:269–78.PubMed Luster M, Lassmann M, Freudenberg LS, Reiners C. Thyroid cancer in childhood: management strategy, including dosimetry and long-term results. Hormones 2007;6:269–78.PubMed
2.
go back to reference Reiners C, Demidchik YE, Drozd VM, Biko J. Thyroid cancer in infants and adolescents after Chernobyl. Minerva Endocrinol 2008;33:381–95.PubMed Reiners C, Demidchik YE, Drozd VM, Biko J. Thyroid cancer in infants and adolescents after Chernobyl. Minerva Endocrinol 2008;33:381–95.PubMed
3.
go back to reference Cardis E, Kesminiene A, Ivanov V, Malakhova I, Shibata Y, Khrouch V, et al. Risk of thyroid cancer after exposure to 131I in childhood. J Natl Cancer Inst 2005;97:724–32.PubMedCrossRef Cardis E, Kesminiene A, Ivanov V, Malakhova I, Shibata Y, Khrouch V, et al. Risk of thyroid cancer after exposure to 131I in childhood. J Natl Cancer Inst 2005;97:724–32.PubMedCrossRef
4.
go back to reference Moysich KB, Menezes RJ, Michalek AM. Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review. Lancet Oncol 2002;3:269–79.PubMedCrossRef Moysich KB, Menezes RJ, Michalek AM. Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review. Lancet Oncol 2002;3:269–79.PubMedCrossRef
5.
go back to reference Ilgan S, Karacalioglu AO, Pabuscu Y, Atac GK, Arslan N, Ozturk E, et al. Iodine-131 treatment and high-resolution CT: results in patients with lung metastases from differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging 2004;31:825–30.PubMedCrossRef Ilgan S, Karacalioglu AO, Pabuscu Y, Atac GK, Arslan N, Ozturk E, et al. Iodine-131 treatment and high-resolution CT: results in patients with lung metastases from differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging 2004;31:825–30.PubMedCrossRef
6.
go back to reference Massin JP, Savoie JC, Garnier H, Guiraudon G, Leger FA, Bacourt F. Pulmonary metastases in differentiated thyroid carcinoma. Study of 58 cases with implications for the primary tumor treatment. Cancer 1984;53:982–92.PubMedCrossRef Massin JP, Savoie JC, Garnier H, Guiraudon G, Leger FA, Bacourt F. Pulmonary metastases in differentiated thyroid carcinoma. Study of 58 cases with implications for the primary tumor treatment. Cancer 1984;53:982–92.PubMedCrossRef
7.
go back to reference Chow SM, Law SC, Mendenhall WM, Au SK, Yau S, Mang O, et al. Differentiated thyroid carcinoma in childhood and adolescence—clinical course and role of radioiodine. Pediatr Blood Cancer 2004;42:176–83.PubMedCrossRef Chow SM, Law SC, Mendenhall WM, Au SK, Yau S, Mang O, et al. Differentiated thyroid carcinoma in childhood and adolescence—clinical course and role of radioiodine. Pediatr Blood Cancer 2004;42:176–83.PubMedCrossRef
8.
go back to reference Rybakov SJ, Komissarenko IV, Tronko ND, Kvachenyuk AN, Bogdanova TI, Kovalenko AE, et al. Thyroid cancer in children of Ukraine after the Chernobyl accident. World J Surg 2000;24:1446–9.PubMedCrossRef Rybakov SJ, Komissarenko IV, Tronko ND, Kvachenyuk AN, Bogdanova TI, Kovalenko AE, et al. Thyroid cancer in children of Ukraine after the Chernobyl accident. World J Surg 2000;24:1446–9.PubMedCrossRef
9.
go back to reference Demidchik YE, Demidchik EP, Reiners C, Biko J, Mine M, Saenko VA, et al. Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg 2006;243:525–32.PubMedCrossRef Demidchik YE, Demidchik EP, Reiners C, Biko J, Mine M, Saenko VA, et al. Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg 2006;243:525–32.PubMedCrossRef
10.
go back to reference Chen L, Shen Y, Luo Q, Yu Y, Lu H, Zhu R. Pulmonary fibrosis following radioiodine therapy of pulmonary metastases from differentiated thyroid carcinoma. Thyroid 2010;20:337–40.PubMedCrossRef Chen L, Shen Y, Luo Q, Yu Y, Lu H, Zhu R. Pulmonary fibrosis following radioiodine therapy of pulmonary metastases from differentiated thyroid carcinoma. Thyroid 2010;20:337–40.PubMedCrossRef
11.
go back to reference Samuel AM, Rajashekharrao B, Shah DH. Pulmonary metastases in children and adolescents with well-differentiated thyroid cancer. J Nucl Med 1998;39:1531–6.PubMed Samuel AM, Rajashekharrao B, Shah DH. Pulmonary metastases in children and adolescents with well-differentiated thyroid cancer. J Nucl Med 1998;39:1531–6.PubMed
12.
go back to reference Hilpert P. Variation of the carbon monoxide diffusing capacity of the lung with the hemoglobin concentration of the blood. Respiration 1971;28:518–25.PubMedCrossRef Hilpert P. Variation of the carbon monoxide diffusing capacity of the lung with the hemoglobin concentration of the blood. Respiration 1971;28:518–25.PubMedCrossRef
13.
go back to reference Sherrill DL, Lebowitz MD, Knudson RJ, Burrows B. Continuous longitudinal regression equations for pulmonary function measures. Eur Respir J 1992;5:452–62.PubMed Sherrill DL, Lebowitz MD, Knudson RJ, Burrows B. Continuous longitudinal regression equations for pulmonary function measures. Eur Respir J 1992;5:452–62.PubMed
14.
go back to reference Kristufek P, Brezina M, Ciutti P, Strmen J, Mayer M. Reference values and modelling of lung function development as transcendent function of age, body height and mass. Bull Eur Physiopathol Respir 1987;23:139–47.PubMed Kristufek P, Brezina M, Ciutti P, Strmen J, Mayer M. Reference values and modelling of lung function development as transcendent function of age, body height and mass. Bull Eur Physiopathol Respir 1987;23:139–47.PubMed
15.
go back to reference Zapletal A, Samanek M, Paul T. Lung function in children and adolescents. Basel: Karger; 1987. Zapletal A, Samanek M, Paul T. Lung function in children and adolescents. Basel: Karger; 1987.
16.
go back to reference Pavy JJ, Denekamp J, Letschert J, Littbrand B, Mornex F, Bernier J, et al. EORTC Late Effects Working Group. Late effects toxicity scoring: the SOMA scale. Radiother Oncol 1995;35:11–5.PubMedCrossRef Pavy JJ, Denekamp J, Letschert J, Littbrand B, Mornex F, Bernier J, et al. EORTC Late Effects Working Group. Late effects toxicity scoring: the SOMA scale. Radiother Oncol 1995;35:11–5.PubMedCrossRef
17.
go back to reference Vågane R, Bruland ØS, Fosså SD, Olsen DR. Radiological and functional assessment of radiation-induced pulmonary damage following breast irradiation. Acta Oncol 2008;47:248–54.PubMedCrossRef Vågane R, Bruland ØS, Fosså SD, Olsen DR. Radiological and functional assessment of radiation-induced pulmonary damage following breast irradiation. Acta Oncol 2008;47:248–54.PubMedCrossRef
18.
go back to reference Tsoutsou PG, Koukourakis MI. Radiation pneumonitis and fibrosis: mechanisms underlying its pathogenesis and implications for future research. Int J Radiat Oncol Biol Phys 2006;66:1281–93.PubMedCrossRef Tsoutsou PG, Koukourakis MI. Radiation pneumonitis and fibrosis: mechanisms underlying its pathogenesis and implications for future research. Int J Radiat Oncol Biol Phys 2006;66:1281–93.PubMedCrossRef
19.
20.
go back to reference Mertens AC, Yasui Y, Liu Y, Stovall M, Hutchinson R, Ginsberg J, et al. Pulmonary complications in survivors of childhood and adolescent cancer. A report from the Childhood Cancer Survivor Study. Cancer 2002;95:2431–41.PubMedCrossRef Mertens AC, Yasui Y, Liu Y, Stovall M, Hutchinson R, Ginsberg J, et al. Pulmonary complications in survivors of childhood and adolescent cancer. A report from the Childhood Cancer Survivor Study. Cancer 2002;95:2431–41.PubMedCrossRef
21.
go back to reference Carver JR, Shapiro CL, Ng A, Jacobs L, Schwartz C, Virgo KS, et al. American Society of Clinical Oncology clinical evidence review of the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol 2007;25:3991–4008.PubMedCrossRef Carver JR, Shapiro CL, Ng A, Jacobs L, Schwartz C, Virgo KS, et al. American Society of Clinical Oncology clinical evidence review of the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol 2007;25:3991–4008.PubMedCrossRef
23.
go back to reference Biko J, Reiners C, Kreissl MC, Verburg FA, Demidchick Y, Drozd V. Favourable course of disease after incomplete remission on (131)I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up. Eur J Nucl Med Mol Imaging 2011;38:651–5.PubMedCrossRef Biko J, Reiners C, Kreissl MC, Verburg FA, Demidchick Y, Drozd V. Favourable course of disease after incomplete remission on (131)I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up. Eur J Nucl Med Mol Imaging 2011;38:651–5.PubMedCrossRef
24.
go back to reference Pawelczak M, David R, Franklin B, Kessler M, Lam L, Shah B. Outcomes of children and adolescents with well-differentiated thyroid carcinoma and pulmonary metastases following 131I treatment: a systematic review. Thyroid 2010;20:1095–101.PubMedCrossRef Pawelczak M, David R, Franklin B, Kessler M, Lam L, Shah B. Outcomes of children and adolescents with well-differentiated thyroid carcinoma and pulmonary metastases following 131I treatment: a systematic review. Thyroid 2010;20:1095–101.PubMedCrossRef
Metadata
Title
Pulmonary fibrosis in youth treated with radioiodine for juvenile thyroid cancer and lung metastases after Chernobyl
Authors
Helge Hebestreit
Johannes Biko
Valentina Drozd
Yuri Demidchik
Antje Burkhardt
Andreas Trusen
Meinrad Beer
Christoph Reiners
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2011
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-011-1841-x

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