ISSN 1302-9940 | e-ISSN 1308-8491

Hzl Arama




The Journal of the Child ocukluk a Hodgkin Lenfoma Nedeniyle Tedavi Gren Hastalarda Tiroid Fonsiyonlarnn Deerlendirilmesi [J Child]
J Child. 2019; 19(3): 124-131 | DOI: 10.5222/j.child.2019.45822

ocukluk a Hodgkin Lenfoma Nedeniyle Tedavi Gren Hastalarda Tiroid Fonsiyonlarnn Deerlendirilmesi

Mehmet Eltan1, Ferhan Akc1, Gnl Aydoan1, Zafer alcolu1, Ali Er2, Hasan nal3, Aya riba4, Mehmet Emin Darendeliler4, Deniz Tucu1
1Salk Bi̇li̇mleri̇ ni̇versi̇tesi̇, Kanuni̇ Sultan Sleyman Ei̇ti̇m Ve Aratrma Hastanesi̇, Pediyatrik Hematoloji̇- Onkoloji̇ Bi̇li̇m Dal
2Salk Bi̇li̇mleri̇ ni̇versi̇tesi̇, Kanuni̇ Sultan Sleyman Ei̇ti̇m Ve Aratrma Hastanesi̇, Radyoloji Bilim Dal
3Salk Bi̇li̇mleri̇ ni̇versi̇tesi̇, Kanuni̇ Sultan Sleyman Ei̇ti̇m Ve Aratrma Hastanesi̇, Pediyatrik Endokrinoloji Bilim Dal
4stanbul niversitesi, Onkoloji Enstits, Radyasyon Onkoloji Ana Bilim Dal

GR ve AMA: ocukluk a Hodgkin Lenfoma tedavisinde sakalm oran ve sresi uzadka, tedavi sonucu gelien yan etkilerin grlme skl artmakta ve tedavinin ge etkileri giderek nem kazanmaktadr. Bu almada ocukluk anda Hodgkin Lenfoma nedeniyle tedavi gren hastalarda, kemoterapi ve radyoterapinin tiroid fonksiyonlar zerine ge yan etkilerinin deerlendirilmesi amaland.
YNTEM ve GERELER: stanbul Salk Bilimleri niversitesi, Kanuni Sultan Sleyman Eitim ve Aratrma Hastanesi, ocuk Hematoloji ve Onkoloji Kliniinde, 1994-2013 yllar arasnda Hodgkin Lenfoma tans ile tedavi grp, remisyonda olarak izlenen, en az 6 aydr tedavi almayan, 34 erkek, 6s kz olmak zere toplam 40 hastann tiroid fonksiyonlar retrospektif olarak incelendi.
BULGULAR: Tan alan hastalarn ya ortalamas 14.136.081(dalm: 4-31), erkek/kz oran 34/6 (%85/%15) idi. Ortalama takip sresi 5.54 3.68 yl (0,92-13,92)idi. Tm hastalara kemoterapi verildi. Boyun blgesine radyoterapi 37 hasta (%92,5) almt. Ortalama radyoterapi dozu 21.48754.48726 Gy idi. Hastalarmzda %72.5 orannda primer hastalk ba-boyun blgesine lokalize idi. B semptomu 7 hastada (%17,5) vard.
Krk hastann 12inde(%30 hasta) hipotiroidi saptand, 5 hastaya (%41) klinik hipotiroidi tansyla replasman tedavisine baland. Bu hastalarn 11i erkek (%91), 1i kzd (%9). Hastalarmzn 5inde (%12.5) yaplan tiroid USGsinde tiroid bezi nodl saptand. Tiroid nodl saptanan toplam 5 hastann 3 erkek (%60), 2si kzd(%40). Hipotiroidi gelime zaman 3.102.02 yl, tiroid nodl oluma zaman 8.907.10 yl olarak saptand. Tiroid sintigrafisi ve tiroid ultrasonografi sonularna gre seilen hasta tiroid biyopsisine ynlendirildi, malinite saptanmad.

TARTIMA ve SONU: Pediatrik Hodgkin Lenfoma hastalarnda radyasyona bal tiroid hastalklar, tedaviden sonraki yllarda, hastalk remisyonda iken geliebilir. zellikle boyun radyoterapisine maruz kalm hastalar, tiroid fonksiyon bozukluklarnn ortaya kmas asndan yakndan takip edilmelidir.

Anahtar Kelimeler: Hodgkin Lenfoma, ocukluk a, kemoterapi, tiroid, ge yan etki

Evaluation of Thyroid Functions in Patients Treated Pediatric Hodgkin Lymphoma

Mehmet Eltan1, Ferhan Akc1, Gnl Aydoan1, Zafer alcolu1, Ali Er2, Hasan nal3, Aya riba4, Mehmet Emin Darendeliler4, Deniz Tucu1
1Universty Of Health Sciences, Kanuni̇ Sultan Sleyman Educaton And Research Hosptal, Department Of Pediatric Hematology- Oncology
2University Of Health Scences, Kanuni̇ Sultan Sleyman Educaton And Research Hosptal, Department Of Pediatric Radiology
3University Of Health Scences, Kanuni̇ Sultan Sleyman Educaton And Research Hosptal, Department Of Pediatric Endocrinology
4Istanbul University, Oncology Institute, Radiation Oncology

INTRODUCTION: As the survival rate and duration increases in the treatment of childhood Hodgkin's Lymphoma, the incidence of side effects resulting from the treatment increases and the late effects of the treatment become increasingly important. The aim of this study was to evaluate the late side effects of chemotherapy and radiotherapy on thyroid functions in patients treated for Hodgkin's Lymphoma in childhood.
METHODS: Thyroid functions of 40 patients who were treated with diagnosis of Hodgkin's Lymphoma, between 1994 and 2013, followed up in remission in Istanbul Health Sciences University, Kanuni Sultan Sleyman Training and Research Hospital, Department of Pediatric Hematology and Oncology, were evaluated retrospectively.
RESULTS: The mean age of the patients was 14.136.081 (range: 4-31) years, and the male / female ratio was 34/6 (85%/15%). The mean follow-up period was 5.543.68 years (0.92-13.92). All patients received chemotherapy. Thirty seven patients (92.5%) received radiotherapy to the neck region. The mean radiotherapy dose was 21.48754.48726 Gy. Primary disease was localized to head and neck region in 72.5% of our patients. B symptoms were present in 7 patients (17.5%).
Hypothyroidism was detected in 12 of 40 patients (30%) and replacement therapy was started in 5 patients (41%) with the diagnosis of clinical hypothyroidism. Eleven (91%) of these patients were male and 1 (9%) was female. Thyroid gland nodules were detected in 5 (12.5%) of our patients. Of 5 patients with thyroid nodules, 3 were male (60%) and 2 were female (40%). Hypothyroidism was 3.102.02 years and thyroid nodule was 8.907.10 years. Three patients who were selected according to thyroid scintigraphy and thyroid ultrasonography results were referred to thyroid biopsy and no malignancy was detected.

DISCUSSION AND CONCLUSION: Radiation-induced thyroid diseases in pediatric Hodgkin's Lymphoma patients may develop during the years following treatment, when the disease is in remission. In particular, patients exposed to neck radiotherapy should be closely monitored for the occurrence of thyroid dysfunction.
Keywords: Hodgkin's Lymphoma, childhood, chemotherapy, thyroid, late side effect

Keywords: Hodgkin's Lymphoma, childhood, chemotherapy, thyroid, late side effect

Mehmet Eltan, Ferhan Akc, Gnl Aydoan, Zafer alcolu, Ali Er, Hasan nal, Aya riba, Mehmet Emin Darendeliler, Deniz Tucu. Evaluation of Thyroid Functions in Patients Treated Pediatric Hodgkin Lymphoma. J Child. 2019; 19(3): 124-131

Sorumlu Yazar: Deniz Tucu, Trkiye
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