This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van Santen, H. M. Articles by van den Bos, C. Search for Related Content PubMed PubMed Citation Articles by van Santen, H. M. Articles by van den Bos, C.

No Damaging Effect of Chemotherapy in Addition to Radiotherapy on the Thyroid Axis in Young Adult Survivors of Childhood Cancer

Departments of Pediatric Endocrinology, Clinical Epidemiology, and Biostatistics, Late Effects Study Group, Medical Informatics, Medical Oncology, Pediatrics and Pediatric Oncology, Emma Children’s Hospital, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands

Address all correspondence and requests for reprints to: H. M. van Santen, M.D., Department of Pediatric Endocrinology, Emma Children’s Hospital, Academic Medical Center, G8-205, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. E-mail: h.m.vansanten{at}amc.uva.nl.

Late effects of treatment for childhood cancer on the thyroid axis are ascribed predominantly to radiotherapy. Whether chemotherapy has an additional detrimental effect is still unclear. Our aim was to evaluate this effect in young adult survivors of a broad spectrum of childhood cancers. The thyroid axis in 205 childhood cancer survivors was evaluated in relation to former use of chemotherapy and radiotherapy (cranial, cranio-spinal, cervical, mediastinal, or thoracic). The mean follow-up time was 17.5 yr. Damage to the thyroid axis was found in 55 patients (26.8%). Thirty-seven patients (18%) had thyroidal disease. Diagnoses varied from TSH elevation to papillary carcinoma. After multivariate analysis, high risk radiation field, irradiation dose, and the diagnosis of non-Hodgkin lymphoma/Hodgkin’s disease were found to be significant risk factors for developing thyroid disease. Treatment with chemotherapy did not have an additional negative effect on the thyroid axis. For the development of central (pituitary or hypothalamic) thyroid dysfunction, patients with a brain tumor were at increased risk. Chemotherapy for childhood cancer does not contribute to the damage on the thyroid axis inflicted by radiotherapy during young adulthood.

This work was supported by Emma Children’s Hospital, Academic Medical Center, Stichting Kindergeneeskundig Kankeronderzoek, Pharmacia BV.

Presented in part at the meeting of the European Society for Pediatric Endocrinology 2001 (abstract published in Pediatr Res 49(Suppl):161A, 2001) and at the meeting of the Société Internationale d’Oncologie Pédiatrique 2001 (abstract published in Med Pediatr Oncol 37:303, 2001).

Abbreviations: ALL, Acute lymphoblastic leukemia; HD, Hodgkin’s disease; NHL, non-Hodgkin lymphoma.

This article has been cited by other articles:

				G. T. Armstrong, C. A. Sklar, M. M. Hudson, and L. L. Robison Long-Term Health Status Among Survivors of Childhood Cancer: Does Sex Matter? J. Clin. Oncol., October 1, 2007; 25(28): 4477 - 4489. [Abstract] [Full Text] [PDF]

				M. L. Metzger, M. M. Hudson, G. W. Somes, R. I. Shorr, C.-S. Li, M. J. Krasin, J. Shelso, C.-H. Pui, and S. C. Howard White Race As a Risk Factor for Hypothyroidism After Treatment for Pediatric Hodgkin's Lymphoma J. Clin. Oncol., April 1, 2006; 24(10): 1516 - 1521. [Abstract] [Full Text] [PDF]

				H K Gleeson and S M Shalet The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours Endocr. Relat. Cancer, December 1, 2004; 11(4): 589 - 602. [Abstract] [Full Text] [PDF]