Thyroid functions in long-term survivors of pediatric hodgkin's lymphoma treated with chemotherapy and radiotherapy

Objective: post-treatment endocrine disturbances are common in cancer patients who have received radiotherapy or chemotherapy. the objective of this study was to evaluate the thyroid functions of long-term survivors of pediatric hodgkin's lymphoma treated with chemotherapy and radiotherapy. methods: thyroid functions of 55 hodgkin's lymphoma patients (m/f:2.05/1) in complete remission were evaluated retrospectively. results: the mean age of the patients at diagnosis was 10.35±4.09 (range: 2.83-17) years and the mean follow-up period was 5.54±3.68 (range: 0.92-13.92) years. all patients received chemotherapy; a total of 50 patients (90.9%) underwent radiotherapy,42 (76.4%) of whom received neck/mantle radiotherapy. thyroid function tests were abnormal in 14 (24.5%) patients and normal - in the remaining 41 (74.5%). a diagnosis of sub clinical and overt hypothyroidism was made in 11 (78.6%) and 3 (21.4%) patients with abnormal thyroid function tests,respectively. nearly one-fourth (21.4%) of all thyroid function disorders were detected in the first year of follow-up. a statistically significant correlation was found between the dose of mantle radiotherapy and thyroid function disorder (p=0.002). in addition,statistically significant correlations were established between thyroid examination or thyroid ultrasonography findings and thyroid functions (p <0.001 or p=0.006,respectively). conclusions: radiation-induced thyroid disorders may develop in pediatric hodgkin's lymphoma patients in complete remission starting as early as the first year after treatment and are dose-dependent. patients,particularly those who have been exposed to radiotherapy of the neck,must be followed up closely for occurrence of thyroid dysfunctions. © journal of clinical research in pediatric endocrinology,published by galenos publishing.