Abstract
This study examines the relative importance of radiotherapy and intensive chemotherapy either alone or in combination in causing thyroid dysfunction. The cancers studied were cerebral tumours, lymphomas, sarcomas and leukaemia. Thyroid dysfunction was identified by a raised serum thyrotrophin stimulating hormone (TSH) level and/or a low serum thyroxine level.
63 children were studied, mean age 7.5y (range 0.2-14.7y), mean follow-up 5.6y (range 0.4-14.8y). Thyroid dysfunction was found in 18/63 (28%. Irradiation to the thyroid ranged from 10-56cGy but abnormal thyroid function was only found when the irradiation dose was >20cGy. The incidence in each of these study groups was:
We conclude that irradiation to the thyroid causes thyroid dysfunction in a significant number of survivors of childhood cancer and that this incidence does not appear to be increased by associated chemotherapy.
The known association of thyroid cancer following irradiation and the possible enhancing effect of an elevated serum TSH suggest that replacement therapy with L-thyroxine should be given whenever TSH levels are raised.
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Abusrewil, S., Mott, M., Oakhill, A. et al. 62 THYROID FUNCTION IN THE SURVIVORS OF CHILDHOOD CANCER. Pediatr Res 24, 527 (1988). https://doi.org/10.1203/00006450-198810000-00083
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DOI: https://doi.org/10.1203/00006450-198810000-00083