Thyroid Functions and Thyroid Lesions in Children with Hodgkin Lymphoma and Central Nervous System Tumors Who Received Radiotherapy to the Head and Neck Region

Öz

Objective: The aim of this study was to assess thyroid function and lesions after radiotherapy to the head and neck region in children with Hodgkin lymphoma (HL) or central nervous system (CNS) tumors. Material and Methods: The study included children diagnosed with HL or CNS tumors who were in complete remission at least one year after completion of chemotherapy (CT) and who had all received radiotherapy (RT) to the head and/or neck. All patients were requested to undergo thyroid function tests and thyroid ultrasonography (USG). Results: A total of 37 patients were included. The mean age was 13.7±3.8 years. The mean follow-up time was 5.09±2.5 years. All patients had CT and RT. Seven (18.9%) patients had subclinical hypothyroidism, and 7 (18.9%) had thyroid USG abnormalities. None of the patients had thyroid malignancy. Age under 10 years at diagnosis, follow-up time of 3 years or more, and an RT dose of 25 Gy or more were found as effective factors for subclinical hypothyroidism development. Only an RT dose of 25 Gy or more was found to be related to thyroid USG abnormalities. Conclusion: Thyroid function tests and thyroid imaging should be routinely examined in any patient who has been treated for cancer to evaluate thyroid dysfunction regardless of clinical findings and the follow-up of these patients should be lifelong.

Anahtar Kelimeler

• Brain tumor
• Hodgkin lymphoma
• Radiotherapy
• Thyroid disorder

Baş Boyun Bölgesine Radyoterapi Uygulanan Hodgkin Lenfoma ve Santral Sinir Sistemi Tümörlü Çocuklarda Tiroid Fonksiyonları ve Tiroid Lezyonları

Öz

Amaç: Bu çalışmanın amacı Hodgkin lenfoma (HL) veya merkezi sinir sistemi (SSS) tümörlü çocuklarda baş ve boyun bölgesine uygulanan radyoterapi sonrası tiroid fonksiyonunu ve lezyonları değerlendirmektir. Gereç ve Yöntemler: Çalışmaya HL veya SSS tümörü tanısı alan, kemoterapi (KT) ve baş boyun bölgesine radyoterapi (RT) tamamlanmasından en az bir yıl sonra tam remisyonda olan çocuklar dahil edildi. Tüm hastalardan tiroid fonksiyon testleri ve tiroid ultrasonografisi (USG) istendi. Bulgular: Çalışmaya toplam 37 hasta dahil edildi. Yaş ortalaması 13.7±3.8’di. Ortalama takip süresi 5.09±2.5 yıldı. Tüm hastalarda BT ve RT mevcuttu. Yedi (%18.9) hastada subklinik hipotiroidi, 7 (%18.9) hastada tiroid USG anormalliği mevcuttu. Hastaların hiçbirinde tiroid malignitesi yoktu. Tanı anında 10 yaşın altında olmak, takip süresinin 3 yıl ve üzerinde olması, RT dozunun 25 Gy veya daha fazla olması subklinik hipotiroidizm gelişimi için etkili faktörler olarak bulundu. Sadece RT dozu 25 Gy veya daha fazlasının tiroid USG anormallikleri ile ilişkili olduğu saptandı. Sonuç: Kanser tedavisi almış her hastada tiroid fonksiyon bozukluğunu değerlendirmek için klinik bulgulara bakılmaksızın tiroid fonksiyon testleri ve tiroid görüntülemesi rutin olarak incelenmeli ve bu hastaların takipleri ömür boyu yapılmalıdır.

Anahtar Kelimeler

• Beyin tümörü
• Hodgkin lenfoma
• Radyoterapi
• Tiroid bozukluğu

Kaynakça

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