Endocrine late effects from multi-modality treatment of neuroblastoma.
Thyroid dysfunction has been reported after 131I-MIBG-treatment for neuroblastoma. In this study, we have evaluated all endocrine functions from patients who were given multi-modality treatment including 131I-MIBG. Twenty-five neuroblastoma survivors who were off therapy for a median period of 6.0 years (range 1.3-11.1) were evaluated and their median age was 8.1 years (range 2.2-14.7). All patients had received 131I-MIBG, 16 chemotherapy, and 16 surgery. Fourteen patients (56%) had permanently elevated thyrotropin levels and 9 received thyroxine. Two patients had a small thyroid volume while 6 had thyroid nodules or cysts. Two boys showed hypergonadotropic hypogonadism. Growth was retarded in 39% of children. Mean Target Height Standard Deviation Score of patients with thyrotropin elevation was lower than those without (P=0.019). Children treated for neuroblastoma with 131I-MIBG, chemotherapy and surgery were seen to be at risk from developing irreversible thyroid function loss, thyroid nodules, hypergonadotropic hypogonadism, and growth retardation. We recommend that during follow-up of neuroblastoma children, special attention should be paid to their endocrine state.
van Santen
H M
HM
Department of Paediatric Endocrinology, Emma Children's Hospital AMC, G8-205, Academic Medical Center (AMC), University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands. h.m.vansanten@amc.uva.nl
de Kraker
J
J
Vulsma
T
T
D019797:3-Iodobenzylguanidine / Q000009:adverse effects*; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004700:Endocrine System Diseases / Q000209:etiology*; D005260:Female; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D007006:Hypogonadism / Q000209:etiology; D007223:Infant; D007457:Iodine Radioisotopes / Q000009:adverse effects*; D008297:Male; D009447:Neuroblastoma / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D017741:Survivors; D013959:Thyroid Diseases / Q000209:etiology; D013972:Thyrotropin / Q000378:metabolism
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D013972:Thyrotropin