TY - JOUR
T1 - Thyroid adenomas and carcinomas following radiotherapy for a hemangioma during infancy
AU - Haddy, Nadia
AU - Andriamboavonjy, Tianarimanana
AU - Paoletti, Catherine
AU - Dondon, Marie Gabrielle
AU - Mousannif, Abdeddahir
AU - Shamsaldin, Akhtar
AU - Doyon, Françoise
AU - Labbé, Martine
AU - Robert, Caroline
AU - Avril, Marie Françoise
AU - Fragu, Philippe
AU - Eschwege, François
AU - Chavaudra, Jean
AU - Schvartz, Claire
AU - Lefkopoulos, Dimitri
AU - Schlumberger, Martin
AU - Diallo, Ibrahima
AU - Vathaire, Florent de
N1 - Funding Information:
This work was supported by the Fondation de France, the Ligue Nationale Contre le Cancer (LNCC) and European Commission Contract F14P-CT95-0009. The authors are grateful to Lorna Saint Ange for editing.
PY - 2009/11/1
Y1 - 2009/11/1
N2 - Background and purpose: A cohort study was performed to investigate the carcinogenic effect of treating skin hemangioma with ionizing radiation during early childhood. This paper presents the incidence of differentiated thyroid adenomas and carcinomas after radiotherapy in this cohort. Methods and materials: Of a total of 8307 patients treated for a skin hemangioma between 1940 and 1973 at the Institut Gustave-Roussy, 4767 were included in an incidence study, among whom 3795 had received radiotherapy. Seventy-three percent were less than 1-year-old at the time of treatment. External radiotherapy, Radium 226, Strontium 90, Yttrium 90, and Phosphorus 32 were used. The radiation dose received by the thyroid during radiotherapy, estimated in 3497 of the 3795 patients using specific software, was 41 mGy on average. Thyroid tumor cases were obtained by sending out a questionnaire, and were verified in pathological reports. Estimates of thyroid cancer specific incidence rates in the French population were obtained from the French cancer registry network. External and internal analyses were performed. Results: During an average follow-up of 35 years, 11 patients developed a differentiated thyroid carcinoma and 44 a thyroid adenoma. The incidence of thyroid adenoma was found to be higher among taller and heavier individuals. The incidence of both thyroid carcinoma and adenoma was higher among non-smoker patients. A significant dose-response relationship was found between the radiation dose received by thyroid and the risk of thyroid cancer (Excess Relative Risk per GY, ERR/Gy: 14.7, 95%CI: 1.6-62.9) and of adenoma (ERR/Gy: 5.7, 95%CI: 0.7-19.4). Conclusion: This study confirms that radiation treatment performed in the past for hemangioma during infancy increased the risk of thyroid carcinoma and adenoma. Patients treated with external radiotherapy or with Radium 226 applicators for hemangiomas have to be more specifically followed up because this is the subgroup in whom the highest doses were received by the thyroid gland (more than 90% of the radiation doses were higher than 100 mGy). They are therefore more at risk of developing thyroid cancer.
AB - Background and purpose: A cohort study was performed to investigate the carcinogenic effect of treating skin hemangioma with ionizing radiation during early childhood. This paper presents the incidence of differentiated thyroid adenomas and carcinomas after radiotherapy in this cohort. Methods and materials: Of a total of 8307 patients treated for a skin hemangioma between 1940 and 1973 at the Institut Gustave-Roussy, 4767 were included in an incidence study, among whom 3795 had received radiotherapy. Seventy-three percent were less than 1-year-old at the time of treatment. External radiotherapy, Radium 226, Strontium 90, Yttrium 90, and Phosphorus 32 were used. The radiation dose received by the thyroid during radiotherapy, estimated in 3497 of the 3795 patients using specific software, was 41 mGy on average. Thyroid tumor cases were obtained by sending out a questionnaire, and were verified in pathological reports. Estimates of thyroid cancer specific incidence rates in the French population were obtained from the French cancer registry network. External and internal analyses were performed. Results: During an average follow-up of 35 years, 11 patients developed a differentiated thyroid carcinoma and 44 a thyroid adenoma. The incidence of thyroid adenoma was found to be higher among taller and heavier individuals. The incidence of both thyroid carcinoma and adenoma was higher among non-smoker patients. A significant dose-response relationship was found between the radiation dose received by thyroid and the risk of thyroid cancer (Excess Relative Risk per GY, ERR/Gy: 14.7, 95%CI: 1.6-62.9) and of adenoma (ERR/Gy: 5.7, 95%CI: 0.7-19.4). Conclusion: This study confirms that radiation treatment performed in the past for hemangioma during infancy increased the risk of thyroid carcinoma and adenoma. Patients treated with external radiotherapy or with Radium 226 applicators for hemangiomas have to be more specifically followed up because this is the subgroup in whom the highest doses were received by the thyroid gland (more than 90% of the radiation doses were higher than 100 mGy). They are therefore more at risk of developing thyroid cancer.
KW - Childhood
KW - Cohort
KW - Hemangioma
KW - Radiation
KW - Thyroid tumor
UR - http://www.scopus.com/inward/record.url?scp=70350772272&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2009.05.011
DO - 10.1016/j.radonc.2009.05.011
M3 - Article
C2 - 19515442
AN - SCOPUS:70350772272
SN - 0167-8140
VL - 93
SP - 377
EP - 382
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -