Second Primary Malignancy Risk After Radioactive Iodine Treatment for Thyroid Cancer: A Systematic Review and Meta-analysis

被引：239

作者：

Sawka, Anna M. ^{[2
,3
,4
]}

Thabane, Lehana ^{[5
,6
]}

Parlea, Luciana ^{[3
,4
]}

Ibrahim-Zada, Irada ^{[1
]}

Tsang, Richard W. ^{[7
]}

Brierley, James D. ^{[7
]}

Straus, Sharon ^{[8
]}

Ezzat, Shereen ^{[9
,10
,11
,12
]}

Goldstein, David P. ^{[13
,14
]}

机构：

[1] Univ Hlth Network, Div Endocrinol, Dept Med, Toronto, ON, Canada

[2] Univ Hlth Network, Dept Med, Toronto, ON, Canada

[3] Univ Toronto, Div Endocrinol, Toronto, ON, Canada

[4] Univ Toronto, Dept Med, Toronto, ON, Canada

[5] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada

[6] St Josephs Healthcare, Ctr Evaluat Med, Hamilton, ON, Canada

[7] Univ Hlth Network, Dept Radiat Oncol, Toronto, ON, Canada

[8] Univ Toronto, Dept Knowledge Translat, Toronto, ON M5S 1A1, Canada

[9] Mt Sinai Hosp, Div Endocrinol, Toronto, ON M5G 1X5, Canada

[10] Mt Sinai Hosp, Dept Med, Toronto, ON M5G 1X5, Canada

[11] Freeman Ctr Endocrine Oncol, Toronto, ON, Canada

[12] Ontario Canc Inst, Toronto, ON M4X 1K9, Canada

[13] Univ Hlth Network, Dept Surg, Toronto, ON, Canada

[14] Univ Hlth Network, Dept Otolaryngol Head & Neck Surg, Toronto, ON, Canada

来源：

THYROID | 2009年 / 19卷 / 05期

基金：

加拿大健康研究院;

关键词：

PRIMARY TUMORS; SURVIVORS; EPIDEMIOLOGY; CARCINOMA; TRENDS;

D O I：

10.1089/thy.2008.0392

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The risk of second primary malignancies (SPMs) associated with cancer therapies is an important concern of thyroid cancer survivors and physicians. Our objective was to determine if the risk of SPMs is increased in individuals with thyroid cancer treated with radioactive iodine (RAI), compared to those not treated with RAI. Methods: We performed a systematic review of the literature and meta-analysis. Two independent reviewers screened citations and reviewed full-text papers. If not reported by the primary authors, the relative risk (RR) of SPMs was calculated by dividing the standardized incidence ratio of SPM in individuals with thyroid cancer treated with RAI compared to those not treated with RAI (with associated 95% confidence intervals [CI]). The natural logarithms of RRs of respective SPMs, weighted by the inverse of the variance, were pooled using fixed effects models and the exponential of the results was reported. Results: Two multi-center studies (one from Europe and the other from North America) were included in this review. The RR of SPMs in thyroid cancer survivors treated with RAI was significantly increased at 1.19 (95% confidence interval [CI] 1.04, 1.36, p = 0.010), relative to thyroid cancer survivors not treated with RAI (data from 16,502 individuals), using a minimum latency period of 2 to 3 years after thyroid cancer diagnosis. The RR of leukemia was also significantly increased in thyroid cancer survivors treated with RAI, with an RR of 2.5 (95% CI 1.13, 5.53, p = 0.024). We did not observe a significantly increased risk of the following cancers related to prior RAI treatment: bladder, breast, central nervous system, colon and rectum, digestive tract, stomach, pancreas, kidney (and renal pelvis), lung, or melanoma of skin. Conclusions: The risk of SPMs in thyroid cancer survivors treated with RAI is slightly increased compared to thyroid cancer survivors not treated with RAI.

引用

页码：451 / 457

页数：7

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