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Thyroid disorders after radiation therapy in childhood

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  • Authors: Bobrova E.I.1, Fadeyev V.V.1, Sotnikov V.M.2, Pavlova M.G.1, Sych Y.P.1, Semochkin S.V.3, Parkhomenko R.A.2, Mazerkina N.A.4, Zheludkova O.G.5
  • Affiliations:
    1. Sechenov First Moscow State Medical University, Moscow
    2. Russian Scientific Center of Roentgeno-Radiology, Moscow
    3. The Russian National Research Medical University named after N.I. Pirogov, Moscow
    4. Burdenko Neurosurgical Institute, Moscow
    5. Federal Scientific Clinical Centre of Pediatric Hematology, Oncology, Immunology named after Dmitry Rogachev, Moscow
  • Issue: Vol 10, No 3 (2014)
  • Pages: 45-52
  • Section: Original Studies
  • URL: https://cet-endojournals.ru/ket/article/view/6802
  • DOI: https://doi.org/10.14341/ket2014345-52
  • Cite item

Abstract


Aim

The aim of our study was to analyze thyroid status in adults after treatment for malignancies in childhood and its relationship with dose and type of radiotherapy.

Material and methods

Thyroid function (TSH, free T4, anti-TPO), thyroid ultrasound and FNA (in case of thyroid nodules more than 1 cm) were evaluated in 106 adults with a history of radiotherapy for brain tumors (BT), acute lymphoblastic leukemia (ALL) and Hodgkin's lymphoma (HL) in childhood and compared with that in healthy controls (n = 33).

  • Group 1 (cranial irradiation 18 Gy): 11 men and 17 women (median age 21.7 ± 4.2 yrs (range 15–30)), 14.6 ± 4 years after treatment for ALL.
  • Group 2 (craniospinal irradiation 35 Gy + boost to the tumor 55 Gy): 28 men and 20 women (median age 19.48 ± 2.76 yrs (range 15 – 26), 7.84 ± 4.68 years after treatment for brain tumors (BT).
  • Group 3 (local irradiation of cervix and mediastinum mean dose 30.9 ± 9.17 Gy): 13 men and 16 women (median age 28.2 ± 6.31 yrs (range 17 – 44), 11.37 ± 7.25 years after treatment for HL.

Results

Maximal incidence of hypothyroidism was in the group 2 – 58.3% (35.4% – primary, 4.2% – central, 18.8% – mixed). Prevalence of hypothyroidism in groups 1 (9.09%) and 3 (17.24%) doesn't significantly differ from controls. Thyroid volume was lower (mean 4.58±2.39 ml) in group 2 (p<0.001) in compare with other groups and control. TSH was higher (mean 3.72±2.51 MEd/l) in the same group in compare with group 1 and control (p=0.001). Incidence of thyroid nodules (10.34% – group 1; 8.3% – group 2; 20.7% – group 3) doesn't significantly differ between groups and controls (p=0.277).

Conclusions

These data indicate that treatment of cancer in childhood is associated with development of thyroid abnormality later during the life, and there is a possible link between craniospinal irradiation and incidence of hypo-thyroidism.


Ekaterina Ivanovna Bobrova

Sechenov First Moscow State Medical University, Moscow

Author for correspondence.
Email: kekskoffe@yandex.ru

Russian Federation MD, PhD-student

Valentin Victorovich Fadeyev

Sechenov First Moscow State Medical University, Moscow

Email: walfad@mail.ru

Russian Federation MD, PhD, Professor, Head of the Endocrinology Chair

Vladimir Mikhailovich Sotnikov

Russian Scientific Center of Roentgeno-Radiology, Moscow

Email: vmsotnikov@mail.ru

Russian Federation MD, PhD, Professor, Leading Researcher, Head of the X-ray and combined therapy methods department

Mariya Gennadyevna Pavlova

Sechenov First Moscow State Medical University, Moscow

Email: mgpavlova@rambler.ru

Russian Federation MD, PhD, Assistance Professor of the Endocrinology Chair

Yuliya Petrovna Sych

Sechenov First Moscow State Medical University, Moscow

Email: juliasytch@mail.ru

Russian Federation MD, PhD, Assistance Professor of the Endocrinology Chair

Sergey Vyacheslavovich Semochkin

The Russian National Research Medical University named after N.I. Pirogov, Moscow

Email: s.semochkin@gmail.com

Russian Federation MD, PhD, Professor of the Oncology and Haematology Chair

Roman Alekseevich Parkhomenko

Russian Scientific Center of Roentgeno-Radiology, Moscow

Email: rparh@mail.ru

Russian Federation MD, PhD, Leading Researcher

Nadezhda Aleksandrovna Mazerkina

Burdenko Neurosurgical Institute, Moscow

Email: nmazer@nsi.ru

Russian Federation MD, PhD

Olga Grigoryevna Zheludkova

Federal Scientific Clinical Centre of Pediatric Hematology, Oncology, Immunology named after Dmitry Rogachev, Moscow

Email: clelud@mail.ru

Russian Federation MD, PhD, Professor, Head of the Oncoendocrinology Department

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Copyright (c) 2014 Bobrova E.I., Fadeyev V.V., Sotnikov V.M., Pavlova M.G., Sych Y.P., Semochkin S.V., Parkhomenko R.A., Mazerkina N.A., Zheludkova O.G.

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