Post-Treatment Thyroid Diseases in Children with Brain Tumors: A Single-Center Experience at "Prof. Dr. Ion Chiricuță" Institute of Oncology, Cluj-Napoca.

Maria Margareta Cosnarovici,Alexandru Mester,Andreea-Ioana Stefan,Eduard-Alexandru Bonci,Rodica Cosnarovici,Maria-Iulia Larg,Andra Piciu,Claudiu-Iulian Bădulescu,Marius-Ioan Bădan

doi:10.3390/diagnostics10030142

Abstract

Aim of study: The purpose of the study was to evaluate the association of thyroid dysfunction occurring in pediatric patients treated for brain tumors. Patients and methods: A total of 255 patients with brain tumors were treated between 2001 and 2018 at the “Prof. Dr. Ion Chiricuță” Institute of Oncology, Cluj-Napoca. Due to a minimum follow-up of 4 years, we studied 184 out of the 255 patients. The cohort included 69 girls (37.5%) and 109 boys (62.5%), with a median age of 8.4 years. The evaluated tumors included medulloblastomas (47 patients), astrocytomas (44 patients), ependymomas (22 patients), gliomas (20 patients), germ cell tumors (12 patients), primitive neuroectodermal tumors (4 patients), as well as other types of tumors (15 patients); in 20 of the cases, biopsy could not be performed. Results: There was a 60% overall survival rate; among the 120 surviving patients, 11 (9.1%) were diagnosed with iatrogenic thyroid disease. We observed an important number of iatrogenic thyroid disease cases in this group of patients, thus revealing the importance of long-term thyroid function evaluation in all children who finalized their treatment for brain tumors. Through this study, we aimed to provide an accurate image of the methodology of monitoring for thyroid dysfunction in childhood brain tumor survivors. Conclusion: Given the fact that the probability of developing thyroid dysfunction in the pediatric population treated for brain tumors is not rare, we recommend that childhood brain tumor survivors be monitored for iatrogenic thyroid disease, in order to provide early diagnosis and treatment.

Highlights

The tumors of the central nervous system, which are represented by histologically diverse neoplasms, represent the second most frequent type of cancer in children after leukemia
The number of long-term survivors of childhood brain tumors has grown compared to the previous decade, and it has become clear that the new tools of oncological treatment may have serious long-term effects
Childhood brain tumor survivors represent a distinct group of patients who require lifelong follow-up and management in order to provide optimal development and quality of life

Summary

Introduction

The tumors of the central nervous system, which are represented by histologically diverse neoplasms, represent the second most frequent type of cancer in children after leukemia. Childhood brain tumors have a relatively poor survival rate compared to other childhood malignancies; this is why efforts to develop new diagnostic and therapeutic tools have greatly increased in recent years. As a result of the development of these new diagnostic and treatment tools, an increasing number of long-term survivors has been registered worldwide, revealing an important number of late side effects. Quality of life in this patient group has become a major field of interest, demonstrating the need for new and improved techniques for managing neurologic, sensory, and endocrinologic deficiencies. The number of long-term survivors of childhood brain tumors has grown compared to the previous decade, and it has become clear that the new tools of oncological treatment may have serious long-term effects. The current focus on diagnosing and managing neurologic and sensory outcomes has proven its utility in improving quality of life in this group of patients

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