Abstract:

Objective To investigate the characteristics and outcomes of radioactive iodine (¹³¹I) therapy in children and adolescents with differentiated thyroid carcinoma (DTC). Methods The clinical and follow-up data of 20 patients with DTC who received initial ¹³¹I treatment at the age ≤21 years old (5 to 21 years old) were retrospectively analysed. There were 18 patients with papillary thyroid carcinoma and 2 with follicular thyroid carcinoma. Seven patients experienced simple lymph node metastases, and 8 had lung metastases. All patients received 131I ablation of residual thyroid tissues. ¹³¹I therapeutic doses of metastatic loci were adjusted according to age, illness status, location of metastasis and uptake of ¹³¹I of lesions. Therapeutic effects were evaluated by ¹³¹I whole body imaging, 18F-FDG tumor imaging and levels of serum thyroglobulin and its receptor, and adverse effects were also observed. Results The median time of follow up was 48.50 months (6 to 110 months), and all the patients survived. The lesions of 13 patients eliminated, 5 improved or controlled, and 2 progressed. Four of the 7 patients with simple lymph node metastases and 4 of the 8 patients with lung metastases experienced lesion elimination. No pulmonary fibrosis, secondary malignancies and abnormity of growth and development were found during follow-up. Conclusion ¹³¹I therapy is an effective and safe method for young patients with DTC, especially for those with metastatic lesions.

Key words: differentiated thyroid carcinoma, iodine radioisotopes, child, adolescent