儿童癌症幸存者（CCS）在接受放射治疗（RT）后存在患第二恶性肿瘤等后遗症的风险。关于CCS在接受RT后甲状腺不典型增生（DTC）的最佳筛查方法仍存在争议。我们评估了接受RT的CCS进行甲状腺超声检查（US）的结果。在2002年至2021年期间，对306名CCS进行了甲状腺US监测。监测取决于初次诊断时的年龄、接受RT的间隔时间和个体提供者。描述了甲状腺US、临床病理特征和结果。探讨了与结节出现风险相关的CCS RT年龄的切点。所选切点用于定义年龄分类，然后用于比较甲状腺结节相关的结果。使用多变量logistic回归（比值比[OR][95%置信区间]）评估了甲状腺结节的风险因素。最常见的CCS诊断包括白血病（32%）、中枢神经系统肿瘤（26%）和神经母细胞瘤（18%）。患者接受全身放疗（45%）和/或颅脊髓放疗（44%）、胸部放疗（11%）和颈部放疗（6%）。约49%（n = 150）的患者存在甲状腺结节。44名患者接受了手术，其中28名患有DTC：19名分类为美国甲状腺协会（ATA）低风险，2名为ATA中风险，7名为ATA高风险疾病。年龄切点分析确定了3和10的切点；因此，≤3岁、>3岁到≤10岁和>10岁的年龄段被使用。在9名中高风险疾病患者中，有8名患者在接受RT时年龄≤10岁，1名患者在接受RT时年龄>10岁。女性（OR = 1.62 [1.13-2.12]，p = 0.054）和RT与首次US之间的时间间隔较长（OR = 1.10 [1.04-1.16]，p = 0.001）是结节出现的独立风险因素。对于在年龄较小时（≤10岁）接受RT的CCS，甲状腺US监测可能有益于更早地检测到DTC，以避免进展为晚期转移性疾病。© 2023 The Author(s). Published by S. Karger AG, Basel.

Childhood cancer survivors (CCS) are at risk for radiotherapy (RT) late effects, including second malignancies. Optimal screening for differentiated thyroid cancer (DTC) in CCS post-RT remains controversial. We assessed the outcome of thyroid ultrasound (US) surveillance in CCS exposed to RT.306 CCS were surveilled with thyroid US between 2002-2021. Surveillance was dependent on age at the time of primary diagnosis, interval from receipt of RT, and individual provider. Thyroid US, clinicopathologic features, and outcomes were described. Cutpoints of CCS RT age associated with varying risk of nodule presentation were explored. The selected cutpoints were used to define age categories, which were then used to compare thyroid nodule-related outcomes. Risk factors for thyroid nodule(s) were evaluated using multivariate logistic regression (odds ratio [OR] [95% confidence interval]).The most common CCS diagnoses were leukemia (32%), CNS tumor (26%), and neuroblastoma (18%). Patients received TBI (45%) and/or RT to craniospinal (44%), chest (11%), and neck regions (6%). About 49% (n = 150) of patients had thyroid nodule(s). Forty-four patients underwent surgery, and 28 had DTC: 19 with American Thyroid Association (ATA) low-risk classification, 2 with ATA intermediate-risk, and 7 with ATA high-risk disease. Age cutpoint analyses identified cutpoints 3 and 10; hence, ≤3, >3 to ≤10, and >10 years were used. Of the 9 patients with intermediate- or high-risk disease, 8 were ≤10 years and 1 was >10 years at the time of RT. Female sex (OR = 1.62 [1.13-2.12] p = 0.054) and greater interval between RT and first US (OR = 1.10 [1.04-1.16] p = 0.001) were independent risk factors for nodule presentation.Thyroid US surveillance may be beneficial for CCS exposed to RT at younger ages (≤10 years) for earlier detection of DTC, prior to developing advanced metastatic disease.© 2023 The Author(s). Published by S. Karger AG, Basel.