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Acute effects on the thyroid gland after non-directed radiation therapy in children and adolescents

Published online by Cambridge University Press:  12 June 2013

C. C. Bonato ,
H. B. Dias ,
M. da S. Alves ,
L. O. Duarte ,
T. M. Dias ,
M. O. Dalenogare ,
C. C. B. Viegas  and
R. H. Elnecave
C. C. Bonato
Affiliation:
Graduate Program in Internal Medicine, Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
H. B. Dias
Affiliation:
Graduate Program in Internal Medicine, Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
M. da S. Alves
Affiliation:
Radiation Therapy Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
L. O. Duarte
Affiliation:
Radiation Therapy Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
T. M. Dias
Affiliation:
Radiation Therapy Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
M. O. Dalenogare
Affiliation:
Radiation Therapy Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
C. C. B. Viegas
Affiliation:
Ionizing Radiation Quality Program, Brazilian National Cancer Institute (INCA), José de Alencar Gomes da Silva, Ministério da Saúde, Rio de Janeiro, RJ, Brazil
R. H. Elnecave*
Affiliation:
Graduate Program in Internal Medicine, Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
*
Correspondence to: Regina Helena Elnecave, Endocrinology Service, HCPA, Rua Ramiro Barcelos, 2350/12, 4° andar, CEP 90035003 Porto Alegre, RS, Brazil. Tel/Fax: +55 51 33598127. E-mail: rhelnecave@gmail.com
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Abstract

Background

During radiation therapy, unwanted scatter to healthy tissues outside the target field may occur. Children and adolescents are more sensitive to radiation injury, and the thyroid gland is particularly susceptible to these effects.

Purpose

To assess acute changes in thyroid function and volume in children and adolescents undergoing radiotherapy for a variety of non-thyroid cancers.

Materials and Methods

Thirty-one children and adolescents underwent radiation therapy of various body areas in which the thyroid was not included. Thyroid-stimulating hormone (TSH), thyroxine (T4), free thyroxine (fT4), triiodothyronine (T3), anti-thyroperoxidase antibodies and thyroglobulin were measured before, on the last day and at 1 and 3 months after the end of radiotherapy. Ultrasound scans were taken and 6- and 24-hour 131I uptake was measured before and after treatment. The scattered dose to the thyroid region was estimated with a treatment planning system or measured with thermoluminescent dosimeters.

Results

The median radiation dose scattered to the thyroid was 296·6 cGy (IQR 16·7–1,709·0). Levels of TSH (p = 0·575), T4 (p = 0·950), fT4 (p = 0·510), T3 (p = 0·842), thyroglobulin (p = 0·620) and anti-thyroid peroxidase antibodies (p = 0·546) were statistically similar at all four time points. There were no differences between pre- and post-radiotherapy thyroid volume and 131I uptake (p = 0·692 and 0·92, respectively).

Conclusion

More sensitive methods may be required to ascertain whether acute injury to the follicular epithelium occurs with lower radiation doses scattered to the thyroid.

Keywords

acute effectsadolescentchildradiotherapythyroid gland
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 13 , Issue 3 , September 2014 , pp. 310 - 316
Copyright
Copyright © Cambridge University Press 2013 

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