The present proposal provides the basis for increasing our understanding of the situation and reinforcing ongoing collaborative research programs between the EU and the NIS countries. A strong relationship will be instituted among the three CIS countries in a way that the epidemiological results in one country may serve as control of an other country.
The Chernobyl reactor accident was unprecedented in scale and in size of the population exposed. Belarus is the most affected country, with nearly 400 cases of thyroid cancer in children and nearly 100 cases in adolescents. Nearly 250 cases have been reported in Ukraine, while a lower, but still significant increase has been reported in the Russian Federation. Preliminary study carried out provided important achievement in understanding the clinical and biological features of radiation-induced thyroid cancer, but further researches are needed to answer several open questions.
The aim of the proposal is to develop basic and clinical experimental design to reach the following objectives:
evaluation of the biological and clinical behavior of radiation-induced thyroid carcinoma as compared with non-radiation-induced thyroid carcinoma. This will allow to assess the response to surgical and medical treatment and, on the basis of the results, to define more appropriate diagnostic and therapeutic protocols. In particular, the following aspects will be studied : the incidence of post-surgical complications; the assessment of disease-free interval after primary surgery and radioiodine therapy; the hormonal, metabolic and immune status of thyroid cancer patients according to type of operation and hormonal treatment, including treatment for post-surgical hypoparathyroidism.
Study of autoimmune diseases in children exposed to post-Chernobyl fall out. Beside thyroid cancer, it is important to assess whether other radiation-induced thyroid disorders, including thyroid autoimmunity has taken place as a consequence of the Chernobyl accident.
Assessment of the effectiveness of l-thyroxine suppressive therapy in childhood thyroid cancer. L-thyroxine (L-T4) is an essential part in the treatment of differentiated thyroid carcinoma. However, L-T4 suppressive therapy in children with thyroid cancer may be a difficult task, because the threshold for feedback regulation of TSH by thyroid hormones is higher in children than in adults. In view of the above consideration, the aim of the research programme is to establish the optimal TSH-suppressive doses of L-T4 to be administered in children and monitor L-T4 treatment in order to avoid drug overdose of incomplete suppression of TSH.
Assessment of iodine deficiency and the need for iodine supplementation in the prevention of radiation-induced thyroid disorders. Dietary iodine deficiency is the major cause of goitre and may result in a number of other disorders, inclosing hypothyroidism. Evidence to date strongly suggests that the secondary rise in TSH in iodine deficiency may play a role in thyroid carcinogenesis.
Implementation of molecular studies. Investigation of oncogenies and other molecular alterations is another major objective of the proposal, which will be carried out in frozen tissues or in paraffin embedded archival material. Cell cultures from post-Chernobyl thyroid carcinomas will also be established in order to perform cellular and molecular investigation in vitro.
Funding SchemeCSC - Cost-sharing contracts