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[Management of 29 children with thyroid cancer following the Chernobyl accident]
A Aurengo1, T Delbot, L Leenhardt
1Service Biophysique 2--Groupe hospitalier Pitié-Salpétrière, Paris.
Insights
The Chernobyl nuclear disaster led to increased thyroid cancer in children. Many survivors required extensive treatment, including surgery and radioiodine therapy, with ongoing monitoring for recurrence.
Area of Science:
- Environmental Health
- Oncology
- Pediatrics
Context:
- Chernobyl nuclear power plant accident's impact on public health.
- Increased incidence of pediatric thyroid cancer in affected regions (Ukraine, Belarus, Russia).
Purpose:
- To report on the clinical management and outcomes of pediatric papillary thyroid cancer patients exposed to Chernobyl radiation.
- To assess treatment effectiveness and long-term prognosis in a cohort of affected children.
Summary:
- Twenty-nine children with papillary thyroid cancer, exposed during the Chernobyl accident, were treated in Paris.
- High rates of metastases (cervical lymph nodes, lungs) were observed. Treatments included surgery and radioiodine therapy.
- While 20 children achieved remission, 6 had persistent lymph node metastases and 3 had evolving lung metastases.
Impact:
- Highlights the long-term health consequences of nuclear accidents, specifically pediatric thyroid cancer.
- Underscores the need for improved screening protocols, specialized treatment facilities (high-activity radioiodine), and sustained funding for managing radiation-induced cancers.
Abstract:
As a consequence of the Chernobyl nuclear power plant accident, a considerable increase of thyroid cancer among contaminated children has been reported in Ukraine, Belarus and Russia. A group of 29 children aged from 5 months to 10 years (mean 4.7 years) at the time of the accident, with a papillary thyroid cancer, have been examined at the Pitié-Salpêtrière hospital in Paris. The cancer was discovered by systematic ultrasonography in only 25% of cases. No reliable dosimetric estimation was achieved. The initial surgical treatment was performed in Ukraine. Cervical lymph node and pulmonary metastases were present in 24 and 11 cases respectively. A complementary surgical treatment was necessary for 9 children and one to four radioiodine treatments were given to 24 children. With a mean delay of 7 years after the cancer discovery, an apparent cure or a remission was obtained for 20 children, 6 children have cervical lymph node metastases requiring a surgical treatment and 3 have evolving lung metastases. The management of the great number of foreseeable cases of thyroid cancer requires an improved systematic screening, a large number of rooms dedicated to high activity radioiodine treatments, funds for disposable material and training missions.