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Subclinical Hypothyroidism in Childhood Cancer Survivors.

 Hyun Joo Lee  ;  Seung Min Hahn  ;  Song Lee Jin  ;  Yoon Jung Shin  ;  Sun Hee Kim  ;  Yoon Sun Lee  ;  Hyo Sun Kim  ;  Chuhl Joo Lyu  ;  Jung Woo Han 
 Yonsei Medical Journal, Vol.57(4) : 915-922, 2016 
Journal Title
 Yonsei Medical Journal 
Issue Date
Age Factors ; Child ; Child, Preschool ; Female ; Humans ; Hypothyroidism/diagnosis* ; Hypothyroidism/etiology* ; Hypothyroidism/mortality ; Infant ; Male ; Neoplasms/complications* ; Neoplasms/mortality ; Neoplasms/therapy ; Retrospective Studies ; Risk Factors ; Survivors*
Hypothyroidism ; child ; neoplasm ; survivor
PURPOSE: In childhood cancer survivors, the most common late effect is thyroid dysfunction, most notably subclinical hypothyroidism (SCH). Our study evaluated the risk factors for persistent SCH in survivors. MATERIALS AND METHODS: Survivors (n=423) were defined as patients who survived at least 2 years after cancer treatment completion. Thyroid function was assessed at this time and several years thereafter. Two groups of survivors with SCH were compared: those who regained normal thyroid function during the follow-up period (normalized group) and those who did not (persistent group). RESULTS: Overall, 104 of the 423 survivors had SCH. SCH was observed in 26% of brain or nasopharyngeal cancer survivors (11 of 43) and 21.6% of leukemia survivors (35 of 162). Sixty-two survivors regained normal thyroid function, 30 remained as persistent SCH, and 12 were lost to follow-up. The follow-up duration was 4.03 (2.15-5.78) years. Brain or nasopharyngeal cancer and Hodgkin disease were more common in the persistent group than in the normalized group (p=0.002). More patients in the persistent group received radiation (p=0.008). Radiation to the head region was higher in this group (2394±2469 cGy) than in the normalized group (894±1591 cGy; p=0.003). On multivariable analysis, lymphoma (p=0.011), brain or nasopharyngeal cancer (p=0.039), and head radiation dose ≥1800 cGy (p=0.039) were significant risk factors for persistent SCH. CONCLUSION: SCH was common in childhood cancer survivors. Brain or nasopharyngeal cancer, lymphoma, and head radiation ≥1800 cGy were significant risk factors for persistent SCH.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
김선희(Kim, Sun Hee)
김효선(Kim, Hyo Sun)
유철주(Lyu, Chuhl Joo) ORCID logo https://orcid.org/0000-0001-7124-7818
이윤선(Ree, Yoon Sun)
이현주(Lee, Hyun Joo) ORCID logo https://orcid.org/0000-0002-1432-0449
진송이(Jin, Song Lee)
한승민(Hahn, Seung Min) ORCID logo https://orcid.org/0000-0001-9832-6380
한정우(Han, Jung Woo) ORCID logo https://orcid.org/0000-0001-8936-1205
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