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Thyroid function in survivors of cancer
S S Abusrewil1, M G Mott, A Oakhill
1Royal Hospital for Sick Children, Bristol.
Archives of Disease in Childhood
|May 1, 1989
Summary
Children treated with thyroid radiotherapy require regular thyroid function tests. Radiotherapy, especially doses over 40 Gy, significantly increases thyroid dysfunction risk in pediatric cancer survivors.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Radiation Oncology
Background:
- Cancer survivors often face long-term health issues, including endocrine dysfunction.
- Thyroid function can be compromised by cancer treatments like radiotherapy and chemotherapy.
Purpose of the Study:
- To assess thyroid function in pediatric cancer survivors treated with different modalities.
- To identify risk factors for thyroid dysfunction post-cancer treatment.
Main Methods:
- Retrospective analysis of 63 pediatric cancer survivors.
- Categorization into three groups based on treatment: thyroid radiotherapy, thyroid radiotherapy plus chemotherapy, and chemotherapy +/- non-thyroid radiotherapy.
- Assessment of thyroid function and correlation with treatment parameters like radiation dose and lymphangiograms.
Main Results:
- Thyroid dysfunction was observed in 29% of survivors, primarily in those receiving radiotherapy to the thyroid.
- All patients with lymphangiograms or radiation doses >40 Gy to the thyroid showed dysfunction.
- Underdiagnosis was noted, with only 9/18 known cases and 15/44 irradiated patients having prior thyroid function tests.
Conclusions:
- Pediatric cancer survivors treated with radiotherapy to the thyroid require consistent thyroid function monitoring.
- Chemotherapy alone does not appear to be a significant risk factor for thyroid dysfunction.
- Longer follow-up is essential to fully understand the long-term endocrine impact.