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01-10-2018 | Original Article

Pulmonary metastases in children and adolescents with papillary thyroid cancer in China: prognostic factors and outcomes from treatment with ¹³¹I

Authors: Xin-Yun Zhang, Hong-Jun Song, Zhong-Ling Qiu, Chen-Tian Shen, Xiao-Yue Chen, Zhen-Kui Sun, Wei-Jun Wei, Guo-Qiang Zhang, Quan-Yong Luo

Published in: Endocrine | Issue 1/2018

Abstract

Purpose

Papillary thyroid carcinoma (PTC) with pulmonary metastases is rare in children and adolescents. Unlike adults, limited data are available on children with this disease. Thus, this study evaluated the therapeutic efficacy and prognostic factors of individuals less than 21 years of age with pulmonary metastases from PTC.

Methods

Seventy-six children and adolescents with pulmonary metastases from PTC treated with ¹³¹I were retrospectively analyzed. Therapeutic efficacy was evaluated by changes in serum thyroglobulin (Tg) and chest computed tomography (CT). Factors predictive of progression-free survival and overall survival were measured by the Kaplan-Meier method.

Results

Among the 76 patients included in this study, 22.4% (17 of 76) were less than 15 years old and 65.8% (50 of 76) were female. Under the evaluation of stimulated serum Tg levels, RAI treatment were effective in 55.9% (38 of 68), stable in 26.5% (18 of 68) and ineffectvie in 17.6% (12 of 68) of patients. Changes on anatomical imaging suggested complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) in 8.5, 62.0, 15.5, and 14.1% of individuals, respectively. Univariate analysis showed that size and tumor doubling time of pulmonary metastases were independent factors affecting therapeutic efficacy. Extra-thyroidal extension, tumor diameter of pulmonary metastases and tumor doubling time were significant independent factors regarding progression-free survival rates, while only tumor doubling time and tumor diameter were significant risk factors associated with overall survival rate.

Conclusions

Radioactive iodine therapy is an effective treatment for children and adolescents with pulmonary metastases from PTC. Extra-thyroid extension was associated with disease progression while did not show significant influence on overall survival. Tumor doubling time and tumor diameter were the main factors influencing both progression-free survival and overall survival.

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Title: Pulmonary metastases in children and adolescents with papillary thyroid cancer in China: prognostic factors and outcomes from treatment with 131I
Authors: Xin-Yun Zhang
Hong-Jun Song
Zhong-Ling Qiu
Chen-Tian Shen
Xiao-Yue Chen
Zhen-Kui Sun
Wei-Jun Wei
Guo-Qiang Zhang
Quan-Yong Luo
Publication date: 01-10-2018
Publisher: Springer US
Published in: Endocrine / Issue 1/2018
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-018-1678-1

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