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The evaluation of function and the ultrasonographic picture of thyroid in children treated for medulloblastoma

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Abstract

Purpose

Medulloblastoma (MB) is one of the most frequent and sensitive to radiation aggressive brain tumor in children. Abnormalities of the thyroid function are common complications of head and neck irradiation for childhood cancer. The aim of this study was to assess thyroid function in children treated for medulloblastoma according to the treatment protocol phase.

Patients and methods

Twenty-three children with MB were enrolled to this study. All patients underwent chemotherapy and radiotherapy to the whole craniospinal axis and boost with the conformal therapy restricted to the tumor bed to a total dose of 54 Gy. Thyroid function was evaluated based on thyroid-stimulating hormone (TSH), free thyroxine (fT4) levels controlled before MB treatment, directly after irradiation and at the end of the treatment protocol. Ultrasonography has been used to detect parenchymal abnormalities.

Results

All patients presented normal thyroid hormone range before chemotherapy. Hypothyroidism was found in 12 patients in the course of treatment, in 2 patients hormone deficits diagnosed directly after irradiation, in 10 patients such condition was observed at the end of the whole therapy. All of these patients needed thyroid hormone substitution. None of them presented clinical symptoms of hypothyroidism. Ultrasound-detected abnormalities have been found in 20 patients.

Conclusions

It is crucial to monitor the functions of the thyroid gland in children treated for medulloblastoma because of the high risk of hypothyroidism resulting from the treatment. The change in the echogenicity of the thyroid gland may be an early marker for a dysfunction of this organ in children treated for medulloblastoma.

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References

  1. Gleeson HK, Shalet SM (2004) The impact of cancer therapy on the endocrine system in survivors of childhood brain tumors. Endocr Relat Cancer 11:589–602

    Article  PubMed  CAS  Google Scholar 

  2. Schmiegelow M, Feldt-Rasmussen U, Rasmussen AK, Paulsen HS, Müller J (2003) A population-based study of thyroid function after radiotherapy and chemotherapy for a childhood brain tumor. J Clin Endocrinol Metab 88:136–140

    Article  PubMed  CAS  Google Scholar 

  3. Corrias A, Einaudi S, Ricardi U, Sandri A, Besenzon L, Altare F, Artesani L, Genitori L, Andreo M, De Sanctis C (2001) Thyroid diseases in patients treated during pre-puberty for medulloblastoma with different radiotherapic protocols. J Endocrinol Invest 24:387–392

    PubMed  CAS  Google Scholar 

  4. Paulino AC (2002) Hypothyroidism in children with medulloblastoma: a comparison of 3600 and 2340 cGY craniospinal radiotherapy. Int J Radiat Oncol Biol Phys 53:43–47

    Article  Google Scholar 

  5. Ricardi U, Corrias A, Einaudi S, Genitori L, Sandri A, de Montezemolo LC, Besenzol L, Madon E, Urgesi A (2001) Thyroid dysfunction as a late effect in childhood medulloblastoma: a comparison of hyperfractionated versus conventionally fractionated craniospinal radiotherapy. Int J Radiat Oncol Biol Phys 50:1287–1294

    Article  PubMed  CAS  Google Scholar 

  6. Nadagopal R, Laverdiere C, Mulrooney D, Hudson MM, Meacham L (2008) Endocrine late effects of childhood cancer therapy: a report from the Children's Oncology Group. Horm Res 69:65–74

    Article  Google Scholar 

  7. Ribi K, Relly C, Landolt MA, Alber RD, Boltshauser E, Grotzen MA (2005) Outcome of medulloblastoma in children: long-term complications and quality of life. Neuropediatrics 36:357–365

    Article  PubMed  CAS  Google Scholar 

  8. Duffner PK, Horowitz ME, Krischer JP (1993) Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumor. N Engl J Med 328:1725–1731

    Article  PubMed  CAS  Google Scholar 

  9. Massimino M, Gandola L, Collini P, Seregni E, Marchiano A, Pignoli E, Spreafico F, Palloti F, Terenziani M, Biassoni V, Bombardieri E, Fossati-Ballani F (2007) Thyroid-stimulating hormone suppression for protection against hypothyroidism due to craniospinal irradiation for childhood medulloblastoma/primitive neuroectodermal tumor. Int J Radiat Oncol Biol Phys 69:404–410

    Article  PubMed  CAS  Google Scholar 

  10. Chin D, Sklar C, Donahue B, Uli N, Geneiser N, Allen J, Nirenberg A, David R, Kohn B, Oberfield SE (1997) Thyroid dysfunction as a late effect in survivors of pediatric medulloblastoma/primitive neuroectodermal tumors: a comparison of hyperfractionated versus conventional radiotherapy. Cancer 80:798–804

    Article  PubMed  CAS  Google Scholar 

  11. Mecham L (2003) Endocrine late effects of childhood cancer therapy. Curr Opin Pediatr Adolesc Health Care 33:217–242

    Article  Google Scholar 

  12. Cohen LE (2005) Endocrine late effects of cancer treatment. Curr Opin Pediatr 34:769–789

    Google Scholar 

  13. Slacmeulder M, Brauner R, Guilhaume B, Habrand JL, Kalifa C, Hartmann O (2003) Post-radiotherapy hyperthyroidism: a rare complication of cancer treatment in the child. Arch Pediatr 10:42–44

    Article  PubMed  CAS  Google Scholar 

  14. Xu W, Janss A, Packer RJ, Goldwein J, Moshang T Jr (2004) Endocrine outcome in children with medulloblastoma treated with 18 Gy of craniospinal radiation therapy. Neuro-oncol 6:113–118

    Article  PubMed  Google Scholar 

  15. Darzy KH (2009) Radiation-induced hypopituitarism after cancer therapy: who, how and when to test. Nat Clin Pract Endocrinol Metab 5:88–99

    Article  PubMed  CAS  Google Scholar 

  16. Slampa P, Pavelka Z, Dusek L, Hynkova L, Sterba J, Ondrova B, Pinc D, Novotny T, Kostakova S (2007) Long-term treatment results of childhood medulloblastoma by craniospinal irradiation in supine position. Neoplasma 54:1–3

    Google Scholar 

  17. Darzy KH, Shalet SM (2005) Hypopituitarism as a consequence of brain tumours and radiotherapy. Pituitary 8:203–211

    Article  PubMed  Google Scholar 

  18. Ivarsson SA, Persson PH, Ericsson UB (1989) Thyroid gland volume as measured by ultrasonography in healthy children and adolescents in a non-iodine deficient area. Acta Paediatr Scand 78:633–634

    Article  PubMed  CAS  Google Scholar 

  19. Birkholz D, Korpal-Szczyrska M, Kamińska H, Bień E, Połczyńska K, Stachowicz-Stencel T, Szołkiewicz A (2005) Influence of surgery and radiotherapy on growth and pubertal development in children treated for brain tumour. Med Wieku Rozwoj 9:463–469

    PubMed  Google Scholar 

  20. Darzy LH, Shalest SM (2009) Hypopituitarism following radiotherapy revisited. Endocr Dev 15:1–24

    Article  PubMed  Google Scholar 

  21. Spoudeas HA, Charmandari E, Brook CG (2003) Hypothalamo–pituitary–adrenal axis integrity after cranial irradiation for childhood posterior fossa tumours. Med Pediatr Oncol 40:224–229

    Article  PubMed  CAS  Google Scholar 

  22. Skowrońska-Gardas A (2009) A literature review of the recent radiotherapy clinical trials in pediatric brain tumors. Rev Recent Clin Trials 4:42–55

    Article  PubMed  Google Scholar 

  23. Crom DB, Kaste SC, Tubergen DG, Greenwald CA, Sharp GB, Hudson MM (1997) Ultrasonography for thyroid screening after head and neck irradiation in childhood cancer survivors. Med Pediatr Oncol 28:15–21

    Article  PubMed  CAS  Google Scholar 

  24. Brignardello E, Corrias A, Isolato G, Palestoni N, Cordero di Montezemolo L, Fagioli F, Boccizi G (2008) Ultrasound screening for thyroid carcinoma in childhood cancer survivors: a case series. J Clin Endocrinol Metab 93:4840–4843

    Article  PubMed  CAS  Google Scholar 

  25. Bhatti P, Veiga LH, Ronckers CM, Sigurdson AJ, Stovall M, Smith SA, Weathers R, Leinsenring W, Mertens AC, Hammond S, Friedman DL, Neglia JP, Meadows AT, Donaldson SS, Sklar CA, Robison LL, Inskip PD (2010) Risk of second primary thyroid cancer after radiotherapy for childhood cancer in a large cohort study: an update from the childhood cancer survivor study. Radiat Res 174:741–752

    Article  PubMed  CAS  Google Scholar 

  26. Pettorini BL, Narducci A, de Carlo A, Abet F, Caldarelli M, Massimi L, Tamburrini G, Di Rocco C (2009) Thyroid neoplasm after central nervous system irradiation for medulloblastoma in childhood: report of two cases. Childs Nerv Syst 25:631–634

    Article  PubMed  Google Scholar 

  27. Barbesino G (2010) Drugs affecting thyroid function. Thyroid 20:763–770

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Pediatric Oncology, Haematology and Chemotherapy, Medical University of Silesia, Upper Silesia Children’s Care Health Centre, 16 Medykow Street, 40-752, Katowice, Poland

    G. Sobol, K. Musioł, A. Mizia-Malarz & H. Woś

  2. Department of Pediatrics, Endocrinology and Adolescent Diabetology, Medical University of Silesia, Upper Silesia Children’s Care Health Centre, 16 Medyków Street, Katowice, Poland

    M. Kalina, B. Kalina-Faska & E. Małecka-Tendera

  3. Department of Radiotherapy, Institute of Oncology, 34 Wybrzeże Armii Krajowej Street, Gliwice, Poland

    K. Ficek

  4. Department of Pediatric Neurosurgery, Medical University of Silesia, Upper Silesia Children’s Care Health Centre, 16 Medyków Street, Katowice, Poland

    M. Mandera

Authors
  1. G. Sobol
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  2. K. Musioł
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  3. M. Kalina
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  4. B. Kalina-Faska
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  5. A. Mizia-Malarz
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  6. K. Ficek
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  7. M. Mandera
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  8. H. Woś
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  9. E. Małecka-Tendera
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Corresponding author

Correspondence to G. Sobol.

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Sobol, G., Musioł, K., Kalina, M. et al. The evaluation of function and the ultrasonographic picture of thyroid in children treated for medulloblastoma. Childs Nerv Syst 28, 399–404 (2012). https://doi.org/10.1007/s00381-011-1625-4

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  • DOI: https://doi.org/10.1007/s00381-011-1625-4

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