title: Abnormalities of the thyroid in survivors of childhood Hodgkin's disease.
abstract: OBJECTIVE
  The progress made in the treatment of Hodgkin's disease (HD) has resulted in long-term survival rates >90%, therefore late sequelae of treatment, especially endocrine diseases, have become more important. Hypothyroidism is the most frequent thyroid disease but hyperthyroidism, thyroid nodules and cancer are also frequent. Thyroid cancer begins to appear 5-10 years after neck irradiation and risk persists for decades. Therefore it is important a careful and long-term follow-up of these patients.
  
  
  METHODS
  This report analyzed the thyroid function of thirteen patients successfully treated for childhood HD according to three different protocols of therapy. Treatment modalities were correlated to the occurrence of thyroid dysfunction.
  
  
  RESULTS
  After a median follow-up of 8.3 years, nine out of thirteen patients were found to have thyroid abnormalities. Six patients developed hypothyroidism, one patient developed hyperthyroidism, two patients showed only ultrasound abnormalities.
  
  
  CONCLUSIONS
  The patients treated with lower radiotherapy (RT) doses and restricted RT extension showed a lower incidence of thyroid abnormalities compared to patients treated with higher RT dose and extended RT field. This study, even though performed in a small cohort of patients, confirms the high incidence of thyroid abnormalities in patients treated for HD and strengthens the importance of a long-term follow-up.
authors.affiliation: Section of Hematology‑Oncology Department of Pediatrics University of Siena, Siena, Italy - elisaguidoni9@gmail.com.
authors.forename: D C
authors.initials: DC
authors.lastname: Rodriquez
authors.forename: E
authors.initials: E
authors.lastname: Guidoni
authors.forename: A
authors.initials: A
authors.lastname: D'ambrosio
authors.forename: F
authors.initials: F
authors.lastname: Pochiero
authors.forename: M
authors.initials: M
authors.lastname: Caini
authors.forename: D
authors.initials: D
authors.lastname: Guglielmucci
authors.forename: M
authors.initials: M
authors.lastname: Lucherini
authors.forename: F
authors.initials: F
authors.lastname: Carra
authors.forename: G
authors.initials: G
authors.lastname: Municchi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D006980:Hyperthyroidism / Q000453:epidemiology / Q000209:etiology*; D007037:Hypothyroidism / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D017741:Survivors; D013961:Thyroid Gland / Q000187:drug effects* / Q000528:radiation effects*; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000209:etiology*; D016606:Thyroid Nodule / Q000209:etiology