title: Thyroid functions in long-term survivors of pediatric Hodgkin's lymphoma treated with chemotherapy and radiotherapy.
abstract: 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 subclinical 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.
authors.affiliation: Division of Pediatric Oncology, Department of Pediatrics, Uludag University, Medical Faculty, Bursa, Turkey. demirkayametin@hotmail.com
authors.forename: Metin
authors.initials: M
authors.lastname: Demirkaya
authors.forename: Betül
authors.initials: B
authors.lastname: Sevinir
authors.forename: Halil
authors.initials: H
authors.lastname: Sağlam
authors.forename: Lütfi
authors.initials: L
authors.lastname: Özkan
authors.forename: Okan
authors.initials: O
authors.lastname: Akacı
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D011832:Radiation Injuries / Q000209:etiology; D012074:Remission Induction; D012189:Retrospective Studies; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000187:drug effects / Q000503:physiopathology* / Q000528:radiation effects; D016606:Thyroid Nodule / Q000209:etiology; D014421:Turkey