Ultrasonography for thyroid screening after head and neck irradiation in childhood cancer survivors

✍ Scribed by Crom, Deborah B.; Kaste, Sue C.; Tubergen, David G.; Greenwald, Carol A.; Sharp, Gerald B.; Hudson, Melissa M.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 52 KB
• Volume: 28
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/(sici)1096-911x(199701)28:1<15::aid-mpo4>3.0.co;2-w

✦ Synopsis

We prospectively used ultrasonography to de-and occurred in nearly half of patients treated tect thyroid abnormalities in 96 long-term survi-with 15 Gy or more directly to the thyroid gland. vors of childhood cancer, who received head Radionuclide scans confirmed the presence of and neck radiation therapy at a median age of thyroid nodules in 13 of 15 patients with ultraso-8.9 years. The median time interval since irradia-nographic evidence of nodules. Six patients had tion was 10.8 years (range 5.6-22.8 years). Most thyroid neoplasia, including one case of papilsurvivors of leukemia received 24 Gy cranial lary carcinoma. All patients with neoplasia had irradiation for central nervous system prophy-nodules demonstrated on ultrasonography. Our laxis; patients with solid tumors received be-experience suggests that in childhood cancer tween 20 and 66 Gy (median 37.5 Gy). The survivors, ultrasonography is a sensitive, aftotal evaluation included clinical history, physi-fordable, and noninvasive means of detecting cal examination, thyroid function tests, and thy-subtle parenchymal abnormalities. We recomroid ultrasonography; radionuclide scans were mend thyroid ultrasonography for childhood performed in patients whose abnormalities per-cancer survivors who recieved head and neck sisted on subsequent ultrasound exams. Clinical irradiation. A baseline study should be obtained history and physical examination revealed thy-within 1 year of completion of therapy. The freroid abnormalities in 14 patients (15%), but ul-quency of subsequent examinations should be trasound detected abnormalities in 42 patients based on the radiation dose and the patient's age (44%). These findings included inhomogeneity at the time of irradiation.

ᮊ 1997 Wiley-Liss, Inc.

(n ϭ 29), cysts (n ϭ 15), and nodules (n ϭ 22)

Key words: thyroid ultrasonography, childhood