Subclinical Hypothyroidism in Childhood Cancer Survivors.
10.3349/ymj.2016.57.4.915
- Author:
Hyun Joo LEE
1
;
Seung Min HAHN
;
Song Lee JIN
;
Yoon Jung SHIN
;
Sun Hee KIM
;
Yoon Sun LEE
;
Hyo Sun KIM
;
Chuhl Joo LYU
;
Jung Woo HAN
Author Information
1. Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. jwhan@yuhs.ac
- Publication Type:Original Article
- Keywords:
Hypothyroidism;
neoplasm;
survivor;
child
- MeSH:
Age Factors;
Child;
Child, Preschool;
Female;
Humans;
Hypothyroidism/*diagnosis/*etiology/mortality;
Infant;
Male;
Neoplasms/*complications/mortality/therapy;
Retrospective Studies;
Risk Factors;
*Survivors
- From:Yonsei Medical Journal
2016;57(4):915-922
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: In childhood cancer survivors, the most common late effect is thyroid dysfunction, most notably subclinical hypothyroidism (SCH). Our study evaluated the risk factors for persistent SCH in survivors. MATERIALS AND METHODS: Survivors (n=423) were defined as patients who survived at least 2 years after cancer treatment completion. Thyroid function was assessed at this time and several years thereafter. Two groups of survivors with SCH were compared: those who regained normal thyroid function during the follow-up period (normalized group) and those who did not (persistent group). RESULTS: Overall, 104 of the 423 survivors had SCH. SCH was observed in 26% of brain or nasopharyngeal cancer survivors (11 of 43) and 21.6% of leukemia survivors (35 of 162). Sixty-two survivors regained normal thyroid function, 30 remained as persistent SCH, and 12 were lost to follow-up. The follow-up duration was 4.03 (2.15-5.78) years. Brain or nasopharyngeal cancer and Hodgkin disease were more common in the persistent group than in the normalized group (p=0.002). More patients in the persistent group received radiation (p=0.008). Radiation to the head region was higher in this group (2394±2469 cGy) than in the normalized group (894±1591 cGy; p=0.003). On multivariable analysis, lymphoma (p=0.011), brain or nasopharyngeal cancer (p=0.039), and head radiation dose ≥1800 cGy (p=0.039) were significant risk factors for persistent SCH. CONCLUSION: SCH was common in childhood cancer survivors. Brain or nasopharyngeal cancer, lymphoma, and head radiation ≥1800 cGy were significant risk factors for persistent SCH.
