Differentiated Thyroid Cancer in the Pediatric/Adolescent Population: Evolution of Treatment. J Pediatr Hematol Oncol 2019 Oct;41(7):532-536
Date
04/30/2019Pubmed ID
31033789DOI
10.1097/MPH.0000000000001493Scopus ID
2-s2.0-85064899499 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
Differentiated thyroid cancer (DTC) is the most common cancer in adolescents and young adults. In 2015, the American Thyroid Association published guidelines for management of pediatric DTC. We report our institutional experience and highlight changing practices and new opportunities. A retrospective analysis of all patients diagnosed with DTC from 2001 to 2016 was performed. Among 59 eligible patients, 31 (53%), 15 (25%), and 13 (22%) had low-risk, intermediate-risk, and high-risk disease, respectively. Half (15/31) of low-risk and all intermediate-risk/high-risk patients received radioactive iodine (I-131) ablation. For low-risk patients, average I-131 dose decreased from 80 to 42.05 mCi, and the percentage of patients who received I-131 decreased over time. Eleven of 16 patients with tumor genomic data were found to have somatic targetable (n=6) or germline (n=5) mutations. Persistent/recurrent disease was only present in high-risk (n=8) and intermediate-risk (n=1) patients. Two patients with iodine-refractory disease received trametinib to enhance radioiodine uptake. All patients were alive at follow-up (median, 5 y; range, 1 to 15 y). Coincident with the recent American Thyroid Association guidelines, the use of I-131 in low-risk patients has decreased over time in our practice. Tumor sequencing and cancer genetic evaluation may help redefine opportunities for treatment of high-risk patients and family counseling.
Author List
Remiker AS, Chuang J, Corathers S, Rutter MM, Rutter MJ, Myer CM 4th, Gelfand MJ, Trout AT, Geller JIAuthor
Allison S. Remiker MD Assistant Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAntineoplastic Agents
Child
Child, Preschool
Female
Humans
Iodine Radioisotopes
Male
Retrospective Studies
Thyroid Neoplasms
Thyroidectomy
Treatment Outcome
Young Adult
