3 december 2018: Lees ook dit artikel: 

https://kanker-actueel.nl/anaplastische-schildklierkanker-atc-is-een-zeldzame-vorm-van-kanker-en-heel-moeilijk-te-behandelen-maar-immuuntherapie-en-gerichte-behandelingen-op-mutaties-en-eiwitexpressie-geven-hoopvolle-resultaten.html

5 januari 2011: Bron: Radiat Res. 2010 Oct 26. [Epub ahead of print]

Wie als baby of kind bestraald is geworden op de borst voor een vergrote thymus, ook met lage dosis, heeft daarmee een beduidend groter risico op het krijgen van schildklierkanker later in haar/zijn leven. Dit risico blijft het hele leven bestaan. Dit blijkt uit een studie die 37 jaar lang kinderen volgde die tussen 1926 en 1957 bestraald waren geworden voor een vergrote thymus en werden vergeleken met kinderen die niet bestraald waren geworden en ook met een studiegroep met gezonde babies en kinderen uit hetzelfde woongebied. De kinderen die bestraald waren geworden blijken een 19x groter risico op schildklierkanker te hebben in vergelijking met degenen die geen bestraling hadden gehad en 12 keer zo groot in vergelijking met leeftiijdgenoten zonder vergrote thymus.  

Radiat Res. 2010 Oct 26. [Epub ahead of print]

Thyroid Cancer Risk 40+ Years after Irradiation for an Enlarged Thymus: An Update of the Hempelmann Cohort.

Adams MJ, Shore RE, Dozier A, Lipshultz SE, Schwartz RG, Constine LS, Pearson TA, Stovall M, Thevenet-Morrison K, Fisher SG.

a Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.

Abstract

Abstract Although ionizing radiation is a known carcinogen, the long-term risk from relatively higher-dose diagnostic procedures during childhood is less well known. We evaluated this risk indirectly by assessing thyroid cancer incidence in a cohort treated with "lower-dose" chest radiotherapy more than 55 years ago. Between 2004 and 2008, we re-surveyed a population-based cohort of subjects treated with radiation for an enlarged thymus during infancy between 1926 and 1957 and their unexposed siblings. Thyroid cancer occurred in 50 irradiated subjects (mean thyroid dose, 1.29 Gy) and in 13 nonirradiated siblings during 334,347 person-years of follow-up. After adjusting for attained age, Jewish religion, sex and history of goiter, the rate ratio for thyroid cancer was 5.6 (95% CI: 3.1-10.8). The adjusted excess relative risk per gray was 3.2 (95% CI: 1.5-6.6). The adjusted excess absolute risk per gray was 2.2 cases (95% CI: 1.4-3.2) per 10,000 person-years. Cumulative thyroid cancer incidence remains elevated in this cohort after a median 57.5 years of follow-up and is dose-dependent. Although the incidence appeared to decrease after 40 years, increased risk remains a lifelong concern in those exposed to lower doses of medical radiation during early childhood.

PMID: 20977298 [PubMed - as supplied by publisher]

Medscape besteedt hier een artikel aan:

Risk for Thyroid Cancer Persists Decades After Childhood Radiation

Source Medscape:  click here for the whole article

The finding comes from an update of a longitudinal study of individuals who were irradiated for thymic enlargement with lower doses of radiation (median, 0.95 Gy; mean, 1.29 Gy) between 1926 and 1957 and who were followed until 1987 for the occurrence of cancer.

The subjects were part of the Hempelmann cohort; Louis Hempelmann, MD, began the study in 1951 at the University of Rochester.

At final follow-up, when the individuals were, on average, 38 years old, those exposed to lower-dose thymic radiation had a risk for thyroid cancer that was roughly 19 times higher than that of their unexposed siblings and 24.3 times higher than that of unrelated subjects of the same age and sex living in New York State.

Irradiating the thymus gland is no longer done, but in the early part of the last century, a misconception about the normal size range of infant thymus glands and the mistaken belief that an enlarged thymus could lead to status lymphaticus and suffocation caused thousands of infants and children to be exposed to thymic radiation.

Dr. Adams and his team sought to determine if the increased cancer risk seen in the Hempelmann cohort persisted. From 2004 to 2008, they resurveyed the surviving members of the cohort, as well as their unexposed siblings. The mean age of the irradiated subjects at the second survey was 58 years.

The researchers found that the risk of developing thyroid cancer was still higher for irradiated subjects than for their siblings. Thyroid cancer occurred in 50 of the 1303 irradiated subjects, who received a mean thyroid dose of 1.29 Gy, and in only 13 of the 1768 nonirradiated siblings.

After adjustment for age, Jewish religion, sex, and history of goiter, the rate ratio for thyroid cancer was 5.6 (95% confidence interval , 3.1 to 10.8).

The risk was also dose dependent. The adjusted excess relative risk per gray was 3.2 (95% CI, 1.5 to 6.6) and the adjusted excess absolute risk per gray was 2.2 cases (95% CI, 1.4 to 3.2) per 10,000 person-years.

 


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