Background: The length of patient survival after cancer treatment is increasing and in some cases does not differ from the average life span in healthy individuals.
Objective and hypotheses: The aim of the study is evaluation of thyroid function after oncologic treatment in children.
Method: A group of 158 patients aged 1625 who underwent oncologic treatment in childhood and the control group −66 children and young adults were examined. The prospective study was conducted in the period between 4 and 19 years after the diagnosis. After physical examination, were assayed the levels of TSH. fT4. and fT3 (Abbott). TPO Ab and Tg Ab (DAKO, Denmark); in patients with hyperthyroidism the TSI Ab (BRAHMS Germany). The ultrasound of the thyroid gland was done using a Siemens-2000 device.
Results: The prevalence of hypothyroidism in the group of patients was statistically significantly higher than in the control group (27.2% vs 6.1%. P=0.001). The occurrence of primary hypothyroidism was correlated with the total anthracycline dose and with the total X-irradiation (XRT) dose. The incidence of autoimmune thyroid diseases was statistically significantly higher in children after BMT. There was a statistically significantly higher prevalence of thyroid nodules in children undergone oncologic treatment. The nodules developed more frequently after XRT anticancer therapy and their prevalence was correlated with the total XRT dose.
Conclusion: i) Primary and secondary hypothyroidism is more prevalent in patients who have received oncologic treatment than in healthy individuals. ii) The cytostatics, especially anthracycline and XRT have an effect on the development of primary hypothyroidism. iii) BMT in children has significant effect of development of hypothyroidism in course of AITD. iv) Cytostatic treatment and XRT contribute to development of potentially neoplastic thyroid nodules.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology