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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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LONG-TERM THYROID DISORDERS IN CHILDREN RECEIVING ONCOLOGIC TREATMENT AND RADIOTHERAPY.

E Karapinar1, M A Varkal1, N Saka1

  • 1Istanbul University, Faculty of Medicine - Pediatrics, Istanbul, Fatih, Turkey.

Acta Endocrinologica (Bucharest, Romania : 2005)
|May 8, 2023
PubMed
Summary

Childhood cancer survivors face a high risk of long-term thyroid disorders, especially after neck radiotherapy. Close monitoring is crucial for detecting these late-emerging endocrine issues.

Keywords:
cancer survivorslong-term side effectsradiotherapythyroid disorder

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Area of Science:

  • Pediatric Oncology
  • Endocrinology
  • Cancer Survivorship

Background:

  • Childhood cancer survival rates have improved significantly.
  • Long-term side effects of cancer treatments, particularly thyroid disorders, are increasingly recognized.
  • Thyroid dysfunction is a common endocrine complication in childhood cancer survivors.

Purpose of the Study:

  • To investigate the risk factors for long-term thyroid disorders (TD) in survivors of leukemia and lymphoma.
  • To identify specific treatment modalities associated with increased risk of TD.
  • To analyze the association between cancer type and TD development.

Main Methods:

  • Retrospective cross-sectional study of 70 childhood cancer survivors (44 acute lymphoblastic leukemia, 26 Hodgkin lymphoma).
  • Thyroid disorder defined by abnormal laboratory and ultrasonographic findings.
  • Risk factors including cancer type and radiotherapy to the neck were analyzed.

Main Results:

  • 40% of survivors developed long-term thyroid disorders.
  • Hodgkin lymphoma survivors had a higher incidence of TD (65%) compared to acute lymphoblastic leukemia survivors (25%).
  • Radiotherapy to the neck was a significant risk factor (57% vs. 17%), identified as the sole determinant in regression models [OR 33.17].

Conclusions:

  • Neck radiotherapy is a critical risk factor for long-term thyroid disorders in childhood cancer survivors.
  • Hodgkin lymphoma diagnosis also significantly increases TD risk.
  • Extended long-term follow-up is essential for monitoring endocrine side effects beyond six years post-treatment.