RESUMEN
The paper analyzes the effectiveness of external beam radiation therapy of medullary thyroid cancer in 38 patients. The radiation therapy of the first phase combined therapy was performed in 9 (24 %) patients: after treatment, 5 patients had a partial response, 4--stabilization. The radiation therapy of the second phase combined therapy was performed in 27 (71%) patients: after treatment, 2 patients had a complete response (booster method), 5--partial response, 4--stabilization. External beam therapy has been performed in 2 (5 %) patients with palliative and symptomatic goals. Additionally has been estimated level of calcitonin in patients after combined treatment. The calcitonin level becomes normal without radiation therapy. Therefore, exposure for medullary thyroid carcinoma is questionable (exception for cases gain exposure to the rest of the tumor).
Asunto(s)
Carcinoma Medular/radioterapia , Cuidados Paliativos/métodos , Neoplasias de la Tiroides/radioterapia , Tiroidectomía , Adulto , Anciano , Calcitonina/sangre , Carcinoma Medular/sangre , Carcinoma Medular/cirugía , Carcinoma Neuroendocrino , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radioterapia Adyuvante , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodos , Resultado del TratamientoRESUMEN
The role of RET and GFRA1 germline polymorphisms in predisposition to sporadic medullary thyroid cancer (MTC) and polymorphisms' modulation effect on clinical features of inherited and sporadic MTC were investigated. Blood samples from 67 MTC patients (22 hereditary and 45 sporadic), 3 asymptomatic mutant RET gene carriers and 178 ethnically matched healthy control individuals were tested. Screening of RET exons and portion of introns 1, 8, 10, 13, 14, 15, 16 and GFRA1 5'-UTR was performed by means of direct sequencing and PCR-RFLP. 8 polymorphic variants of RET gene (exons 11, 13, 14, 15 and introns 1, 8, 13, 14) and 4 GFRA1 polymorphisms in GFRA1 were detected. Linkage disequilibrium was found between RET variants G691S and S904S, L769L and IVS8, S836S and IVS13. In sporadic MTCs, allelic frequency of only one polymorphic RET variant, L769L, was significantly decreased versus control group. In hereditary MTCs, a significant over-representation of S836S and under-representation of S904S sequence variants were observed as compared to sporadic MTCs and controls. No co-segregation was found between individual polymorphisms and phenotype of sporadic MTC. In patients with inherited MTC whose genotype was presented with polymorphic L769L and wild-type S836S, disease onset occurred 20 years later than in individuals with polymorphic L769L and S836S or wild-type L769L (p = 0.01) suggestive of a possible protective role of L769L in MTC development and modulating effect of a combination of L769L with wild-type S836S on clinical outcome of inherited MTC.
Asunto(s)
Carcinoma Medular/genética , Predisposición Genética a la Enfermedad , Receptores del Factor Neurotrófico Derivado de la Línea Celular Glial/genética , Proteínas de Neoplasias/genética , Polimorfismo de Longitud del Fragmento de Restricción , Neoplasias de la Tiroides/genética , Adolescente , Adulto , Alelos , Niño , Femenino , Frecuencia de los Genes/genética , Humanos , Desequilibrio de Ligamiento/genética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de TiempoRESUMEN
Fine-needle aspiration biopsy of cervical lymph nodes was carried out in 22 patients with suspected metastatic involvement with medullary thyroid carcinoma (MTS). It was followed by cytopathological examination of aspirates and assay of of thyrocalcitonin (TCT) in fine-needle washings. TCT determinations proved highly informative as well as significantly high in all seven cases of MTS involvement (26-8,484.87 pg/ml, mean 2,208 +/- 1,722 pg/ml).
Asunto(s)
Biomarcadores de Tumor/análisis , Calcitonina/análisis , Carcinoma Medular/diagnóstico , Ganglios Linfáticos/química , Neoplasias de la Tiroides/diagnóstico , Adolescente , Adulto , Biopsia con Aguja Fina , Carcinoma Medular/química , Carcinoma Medular/patología , Niño , Femenino , Humanos , Metástasis Linfática/diagnóstico , Masculino , Persona de Mediana Edad , Cuello , Neoplasias de la Tiroides/química , Neoplasias de la Tiroides/patologíaRESUMEN
Beginning approximately 4 years after the Chernobyl nuclear accident a steady increase in the incidence of thyroid cancer was observed in children and adolescents of the Bryansk Oblast, which received the highest level of radionuclide contaminants in Russia. We examined the spatial relationship between the residence location of patients with identified thyroid cancer (0-18 years old at the time of the accident) and a number of geographic parameters to better account for the etiology of thyroid cancer spatial distribution. Geographic parameters analyzed included spatial distribution of 137Cs and 131I in soil, population demographics, measurements and reconstructions. of absorbed thyroid 131I doses in the population, and maps of major transportation arteries. An interesting finding is the lack of a consistent correlation between the spatial distribution of radionuclides in the soil and thyroid cancer incidence. Instead, most of the thyroid cancer cases were diagnosed in settlements situated on major railways and roads. Correlating population with thyroid cancer cases and transportation arteries reveals a much higher cancer rate on or near major roads and railways than at a distance from them, again independent of radionuclide soil concentration. There are other important factors, of course, that must be considered in future evaluations of this phenomenon. These include the influence of iodine endemic zones, genetic predisposition to thyroid cancer, and duration of residence time in contaminated areas. The feasibility of radionuclide transport on railways and roads is discussed, together with the vectors for transfer of the contaminants to the human population. Developing a model to reconstruct the radiation dose to the thyroid over time in this geographic region is proposed in light of the impact of transportation arteries. Specific studies are outlined to provide the data necessary to develop this model as well as to better characterize the feasibility and scientific validity of the contribution to human health effects of this transport factor. Transport factor refers to the transport of radionuclides on transportation arteries and the transfer of these agents to the human population residing in the vicinity of these arteries. If the impact on thyroid cancer of the transport of radionuclides on major railways and roads is indeed significant, a major reappraisal of the risk of large-scale radioactive release into the environment is necessary.