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Changes in thyroid hormone state in children receiving chemotherapy

H M van Santen1, N M Thonissen, J de Kraker

  • 1Department of Paediatric Endocrinology, Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. h.m.vansanten@amc.uva.nl

Clinical Endocrinology
|January 27, 2005
PubMed

Insights

Thyroid function in children with cancer significantly changes during chemotherapy, with hormone levels affected by medications like dexamethasone, not physical well-being. Further research is needed for patient care interventions.

Area of Science:

  • Pediatric Endocrinology
  • Oncology
  • Pharmacology

Background:

  • Thyroid function can be altered during severe illness.
  • Chemotherapy and associated medications may impact endocrine function in pediatric cancer patients.

Purpose of the Study:

  • To quantify changes in thyroid function determinants during chemotherapy in children with cancer.
  • To correlate these changes with clinical condition and specific drug treatments.

Main Methods:

  • Evaluated pediatric oncology patients undergoing chemotherapy over a 3-month period.
  • Excluded patients with brain tumors, neuroblastoma, spinal irradiation, or prior dexamethasone use.
  • Measured plasma concentrations of thyroid hormones (T4, T3, rT3, TSH, TBG, Tg), IGF-1, cortisol, and PRL before and during chemotherapy.

Main Results:

  • Analyzed 123 plasma samples from 19 children across 46 chemotherapy courses.
  • Observed significant decreases in TSH, T3, Tg, and cortisol, and an increase in rT3 during chemotherapy.
  • Aberrant thyroid parameters were noted in 87% of courses; IGF-1 was low in 53% of patients. Dexamethasone use was linked to most hormone changes.

Conclusions:

  • Chemotherapy significantly alters thyroid hormone status in pediatric cancer patients.
  • These changes are primarily attributed to administered drugs, not physical well-being.
  • Future research should explore clinical implications and potential interventions.
Abstract

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