Metachronous thyroid tumors in children after radiation treatment of malignant tumors of the head and neck: the registry of the D. Rogachev NMRCPHOI

Radiation therapy (RT) is one of the methods used to treat malignant tumors of the head and neck in children. The thyroid gland is among the organs most sensitive to radiation exposure. After radiation therapy, changes such as hypothyroidism, autoimmune thyroiditis, and nodules of various origins are often observed in the thyroid. There is a clear correlation between the total radiation dose delivered to the thyroid gland and the condition that develops after the exposure. The risk of nodule development increases with RT doses of 25 Gy or more, and gradually decreases when the total radiation dose exceeds 30 Gy due to the destruction of thyrocytes. The younger the child, the higher the risk of developing hypothyroidism and thyroid carcinoma as a result of an increased number of mitoses in the cells of the organ and the potential for mutations due to DNA damage. The development of radiation-induced thyroid cancer is a late complication of RT: the interval between the treatment completion and the detection of carcinoma ranges from 5 to 29 years. Thus, children with a history of RT for head and neck masses require strict life-long followup by an endocrinologist for early detection of the thyroid gland disorders and initiation of appropriate treatment.
Keywords: metachronous thyroid tumor in children, radiation therapy of the head and neck in children
Conflict of interest. The authors declare that there is no conflict of interest.
Funding. The study has not received any funding.