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Piccardo A, Foppiani L, Puntoni M, Hanau G, Calafiore L, Garaventa A, Arlandini A, Villavecchia G, Bianchi P, Cabria M. Role of low-cost thyroid follow-up in children treated with radiotherapy for primary tumors at high risk of developing a second thyroid tumor. Q J Nucl Med Mol Imaging 2012; 56:459-467. [PMID: 23090072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM Differentiated thyroid cancer (DTC) is uncommon in childhood and data on its prevalence as a second malignant neoplasm (SNM) after radiotherapy (RT) for malignancies are limited. We evaluated: 1) the incidence DTC in pediatric-oncologic patients treated with RT; 2) the relationship between DTC, RT and the features of the first malignancy; 3) the usefulness of thyroid follow-up in irradiated oncological patients. METHODS We have followed up 252 patients treated with RT out of 966 oncologic pediatric patients. Thyroid follow-up included TSH level evaluation and neck ultrasonography. In the presence of thyroid nodule/s ≥1 cm and/or with ultrasonography suspicious for malignancy, fine needle aspiration biopsy (FNAB) was performed. When papillary/follicular lesions were detected by cytology, thyroidectomy was performed. If DTC was confirmed, patients underwent radioactive iodine (RAI) treatment. RESULTS At least one thyroid nodule was detected in 106 irradiated patients (42%): 45 patients underwent FNAB and 27 underwent thyroidectomy. Seventeen DTC (6.7%) were found on histology. A higher incidence of DTC was seen in patients with neuroblastoma (38%) or Wilms' tumor (18%). One third of DTC showed capsule invasion, and one fourth node involvement. Eleven patients, treated with a single RAI treatment, showed undetectable thyroglobulin levels after rh-TSH-stimulation. Five patients underwent at least two RAI treatments: four patients showed complete remission and one patient partial remission. CONCLUSION A high rate of DTC, often with invasive features, was observed in children treated with RT for primary tumors. This finding underlines the usefulness of thorough low-cost thyroid follow-up in this high-risk population.
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Affiliation(s)
- A Piccardo
- Nuclear Medicine, Galliera Hospital, Genoa, Italy.
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Luksch R, Grignani G, Fagioli F, Brach del Prever A, Podda M, Aliberti S, Casanova M, Prete A, Hanau G, Tamburini A, Allione P, Tienghi A, Ferrari S, Collini P, Marchianò A, Gandola L, Aglietta M, Madon E, Picci P, Fossati-Bellani F. Response to melphalan in up-front investigational window therapy for patients with metastatic Ewing's family tumours. Eur J Cancer 2007; 43:885-90. [PMID: 17254770 DOI: 10.1016/j.ejca.2006.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2006] [Accepted: 09/23/2006] [Indexed: 11/20/2022]
Abstract
The aim of the study was to determine the activity and toxicity of melphalan as a single agent given in up-front therapy for patients with newly-diagnosed Ewing's family tumours with bone/bone marrow metastases. Nineteen patients were enrolled from 2001 to 2004. The treatment consisted of up-front therapy with melphalan (two courses of 50 mg/m2, 3 weeks apart). The overall rate of response to melphalan (complete response+partial response, according to the RECIST criteria) was 78%. Transient grade 3-4 neutropenia, thrombocytopenia and anaemia were recorded in 97%, 81% and 28% of melphalan courses, respectively. No other relevant toxicities were recorded. Melphalan proved to be active in up-front treatment at non-myeloablative doses, and its toxicity was predictable and manageable. The schedule adopted did not interfere with any further intensive chemotherapy or myeloablative treatment in the majority of cases.
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Affiliation(s)
- R Luksch
- Istituto Nazionale per lo Studio e la Cura dei Tumori di Milano, Milan, Italy.
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De Caro E, Fioredda F, Calevo MG, Smeraldi A, Saitta M, Hanau G, Faraci M, Grisolia F, Dini G, Pongiglione G, Haupt R. Exercise capacity in apparently healthy survivors of cancer. Arch Dis Child 2006; 91:47-51. [PMID: 16188959 PMCID: PMC2083103 DOI: 10.1136/adc.2004.071241] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS To evaluate cardiopulmonary exercise tolerance in a large cohort of apparently healthy paediatric cancer survivors in order to determine their participation in sporting activities. METHODS A total of 84 young (<21 years) asymptomatic childhood cancer survivors, who had been exposed to anthracyclines (mean dose 212 mg/m2) and/or chest irradiation (median dose 2000 cGy), with normal left ventricular systolic function at rest (fractional shortening >29%), and 79 healthy controls were studied. Exercise testing was performed on a treadmill ergometer. Gas exchange analysis and derived variables were measured on a breath-by-breath basis. Pulmonary functional evaluation was performed before exercise. Echocardiographic evaluation at rest was performed within one month before the exercise test. RESULTS There were no differences in exercise responses between patients and controls. In boys <13 years, mean VO2 max was slightly but significantly lower than in controls. This finding was thought to be a result of decreased physical fitness as all the other exercise parameters were similar to those in the controls. CONCLUSIONS Results show that apparently healthy survivors of paediatric cancer can take part in dynamic sporting activities if they exhibit a normal response to cardiopulmonary exercise testing, while those that exhibit a reduced VO2 max should be re-evaluated after an aerobic training programme, and should undergo tailored dynamic physical activity if the VO2 max does not normalise.
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Affiliation(s)
- E De Caro
- Department of Cardiology, Giannina Gaslini Children's Hospital, Genoa, Italy
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Luksch R, Fagioli F, Grignani E, Aliberti S, Casanova M, Hanau G, Tamburini A, Prete A, Ferrari S, Picci P. Up-front melphalan in Ewing's family tumors with bone/bone marrow metastases at onset (very-high risk EFTs). A report from ISG/AIEOP “Very High Risk EFTs Cooperative Study”. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Luksch
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - F. Fagioli
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - E. Grignani
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - S. Aliberti
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - M. Casanova
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - G. Hanau
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - A. Tamburini
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - A. Prete
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - S. Ferrari
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - P. Picci
- Istituto Nazionale Tumori, Milano, Italy; OIRM S.Anna, Torino, Italy; IRCC, Candiolo, Italy; Istituto Giannina Gaslini, Genova, Italy; Ospedale Meyer, Firenze, Italy; Policlinico S.Orsola, Bologna, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
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