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

1997; Alan R. Liss, Inc.; Volume: 28; Issue: 1 Linguagem: Inglês

10.1002/(sici)1096-911x(199701)28

1096-911X

Deborah B. Crom, Sue C. Kaste, David G. Tubergen, Carol Greenwald, Gerald B. Sharp, Melissa M. Hudson,

Head and Neck Anomalies

Medical and Pediatric OncologyVolume 28, Issue 1 p. 15-21 Ultrasonography for thyroid screening after head and neck irradiation in childhood cancer survivors Deborah B. Crom MSN, Corresponding Author Deborah B. Crom MSN Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeDepartment of Hematology-Oncology, St. Jude Children's Research Hospital, P.O. Box 318, Memphis, TN 38101-0318Search for more papers by this authorSue C. Kaste DO, Sue C. Kaste DO Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorDavid G. Tubergen MD, David G. Tubergen MD Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorCarol A. Greenwald MD, Carol A. Greenwald MD Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorGerald B. Sharp DrPH, Gerald B. Sharp DrPH Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorMelissa M. Hudson MD, Melissa M. Hudson MD Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this author Deborah B. Crom MSN, Corresponding Author Deborah B. Crom MSN Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeDepartment of Hematology-Oncology, St. Jude Children's Research Hospital, P.O. Box 318, Memphis, TN 38101-0318Search for more papers by this authorSue C. Kaste DO, Sue C. Kaste DO Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorDavid G. Tubergen MD, David G. Tubergen MD Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorCarol A. Greenwald MD, Carol A. Greenwald MD Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorGerald B. Sharp DrPH, Gerald B. Sharp DrPH Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this authorMelissa M. Hudson MD, Melissa M. Hudson MD Departments of Hematology-Oncology, Diagnostic Imaging, and Radiation Oncology, St. Jude Children's Research Hospital and Departments of Pediatrics, Radiology, and Radiation Therapy, University of Tennessee, College of Medicine, Memphis, TennesseeSearch for more papers by this author First published: 07 December 1998 https://doi.org/10.1002/(SICI)1096-911X(199701)28:1 3.0.CO;2-WCitations: 55AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract We prospectively used ultrasonography to detect thyroid abnormalities in 96 long-term survivors of childhood cancer, who received head and neck radiation therapy at a median age of 8.9 years. The median time interval since irradiation was 10.8 years (range 5.6–22.8 years). Most survivors of leukemia received 24 Gy cranial irradiation for central nervous system prophylaxis; patients with solid tumors received between 20 and 66 Gy (median 37.5 Gy). The total evaluation included clinical history, physical examination, thyroid function tests, and thyroid ultrasonography; radionuclide scans were performed in patients whose abnormalities persisted on subsequent ultrasound exams. Clinical history and physical examination revealed thyroid abnormalities in 14 patients (15%), but ultrasound detected abnormalities in 42 patients (44%). These findings included inhomogeneity (n = 29), cysts (n = 15), and nodules (n = 22) and occurred in nearly half of patients treated with 15 Gy or more directly to the thyroid gland. Radionuclide scans confirmed the presence of thyroid nodules in 13 of 15 patients with ultrasonographic evidence of nodules. Six patients had thyroid neoplasia, including one case of papillary carcinoma. All patients with neoplasia had nodules demonstrated on ultrasonography. Our experience suggests that in childhood cancer survivors, ultrasonography is a sensitive, affordable, and noninvasive means of detecting subtle parenchymal abnormalities. We recommend thyroid ultrasonography for childhood cancer survivors who recieved head and neck irradiation. A baseline study should be obtained within 1 year of completion of therapy. The frequency of subsequent examinations should be based on the radiation dose and the patient's age at the time of irradiation. © 1997 Wiley-Liss, Inc. Citing Literature Volume28, Issue1January 1997Pages 15-21 RelatedInformation