Volume 66, Issue 5 pp. 727-731

Thyroid function in paediatric and young adult patients after sarcoma therapy: a report from the Late Effects Surveillance System

M. Paulides,

M. Paulides

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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H. G. Dörr,

H. G. Dörr

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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W. Stöhr,

W. Stöhr

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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S. Bielack,

S. Bielack

Cooperative Osteosarcoma Study Group Center and

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E. Koscielniak,

E. Koscielniak

Cooperative Soft Tissue Sarcoma Study Center, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany,

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T. Klingebiel,

T. Klingebiel

Cooperative Soft Tissue Sarcoma Study Center, University Hospital for Pediatrics III (Pediatric Hematology, Oncology and, Hemostaseology), Frankfurt, Germany,

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H. Jürgens,

H. Jürgens

Ewing's Sarcoma Trial Center, University Childrens’ Hospital Muenster, Department of Pediatric Hematology and Oncology, Muenster, Germany,

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T. Bölling,

T. Bölling

RiSK Study Center, Department of Radiotherapy, University Hospital Muenster, Muenster, Germany,

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N. Willich,

N. Willich

RiSK Study Center, Department of Radiotherapy, University Hospital Muenster, Muenster, Germany,

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R. Sauer,

R. Sauer

Department of Radiation Therapy, University Medical Center Erlangen-Nuremberg, Erlangen, Germany

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T. Langer,

T. Langer

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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J. D. Beck,

J. D. Beck

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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M. Paulides,

M. Paulides

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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H. G. Dörr,

H. G. Dörr

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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W. Stöhr,

W. Stöhr

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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S. Bielack,

S. Bielack

Cooperative Osteosarcoma Study Group Center and

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E. Koscielniak,

E. Koscielniak

Cooperative Soft Tissue Sarcoma Study Center, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany,

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T. Klingebiel,

T. Klingebiel

Cooperative Soft Tissue Sarcoma Study Center, University Hospital for Pediatrics III (Pediatric Hematology, Oncology and, Hemostaseology), Frankfurt, Germany,

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H. Jürgens,

H. Jürgens

Ewing's Sarcoma Trial Center, University Childrens’ Hospital Muenster, Department of Pediatric Hematology and Oncology, Muenster, Germany,

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T. Bölling,

T. Bölling

RiSK Study Center, Department of Radiotherapy, University Hospital Muenster, Muenster, Germany,

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N. Willich,

N. Willich

RiSK Study Center, Department of Radiotherapy, University Hospital Muenster, Muenster, Germany,

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R. Sauer,

R. Sauer

Department of Radiation Therapy, University Medical Center Erlangen-Nuremberg, Erlangen, Germany

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T. Langer,

T. Langer

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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J. D. Beck,

J. D. Beck

LESS Study Center, University Hospital for Children and Adolescents, Erlangen, Germany,

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First published: 23 March 2007

https://doi.org/10.1111/j.1365-2265.2007.02813.x

Citations: 22

J. D. Beck, Late Effects Surveillance System, Department of Pediatric Oncology and Immunology, University Hospital for Children and Adolescents, Loschgestrasse 15, D-91054 Erlangen, Germany. Tel.: +49 9131 85 33731; Fax: +49 9131 85 35742; E-mail: [email protected]

Thorsten Langer and Jörn-Dirk Beck have contributed equally to this work.

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Summary

Objective The role of chemotherapy in thyroid sequelae after cancer treatment has not been studied systematically, especially in sarcoma patients. The aim of this study was to determine the incidence of post-therapeutic thyroid disorders and their contributing factors in a cohort of paediatric sarcoma patients.

Design Late effects of sarcoma treatment have been collected prospectively within the Late Effects Surveillance System (LESS) in Germany, Austria and Switzerland since 1998.

Patients We studied 340 relapse-free paediatric patients (median age at diagnosis 12·2 [interquartile range (IQR) = 7·3–15·6 years] treated for osteosarcoma, soft tissue sarcoma or Ewing's sarcoma within the COSS-96, CWS-96/CWS-2002P or EICESS-92/EURO-E.W.I.N.G.-99 therapy trials. In addition to polychemotherapy, 127 patients were irradiated (mean cumulative dose 47 ± 9·7 Gy), including 51 patients with irradiation to the head/neck region. Median follow-up was 24·6 (IQR = 11·9–44·9) months.

Measurements We reviewed the results of yearly examinations of serum TSH and fT4 levels and thyroid ultrasound examinations.

Results The incidence of thyroid disorders was 37% (19/51, 95% CI 24–52%) in patients with head/neck irradiation, and 11% (32/289, 95% CI 8–15%) in patients without irradiation to the head/neck. Thyroid disorders were more frequent in patients treated with idarubicin (P = 0·027) and trofosfamide (P = 0·016). We also found a significant association between raised TSH levels and treatment with trofosfamide (P = 0·008) or idarubicin (P = 0·037) (n = 250).

Conclusions The incidence of thyroid disorders in the head/neck-irradiated group was high. Even without head/neck irradiation, we found an increased proportion of patients with thyroid disorders, possibly as a result of chemotherapy.

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Volume66, Issue5

May 2007

Pages 727-731

Thyroid function in paediatric and young adult patients after sarcoma therapy: a report from the Late Effects Surveillance System

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Thyroid function in paediatric and young adult patients after sarcoma therapy: a report from the Late Effects Surveillance System

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