Abstract：
BACKGROUND: Survival in paediatric patients with Hodgkin lymphoma (HL) has increased over the last decades. However, these patients are at increased risk of developing late thyroid sequelae due to the treatment with irradiation and alkylating agents.
METHODS: We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves.
RESULTS: Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of follow-up was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (P= .026), thyroid nodules (P= .01) and thyroid disease overall (P= .003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; P= .017).
CONCLUSIONS: Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the follow-up. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease.
METHODS: We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves.
RESULTS: Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of follow-up was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (P= .026), thyroid nodules (P= .01) and thyroid disease overall (P= .003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; P= .017).
CONCLUSIONS: Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the follow-up. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease.
摘要：
背景：小儿霍奇金淋巴瘤（HL）患者的生存率在过去几十年中有所增加。然而,这些患者因接受放疗和烷化剂治疗而出现晚期甲状腺后遗症的风险增加.
方法：我们对2007年至2022年间诊断为HL的患者进行了一项观察性和回顾性研究，该研究是儿科肿瘤学参考中心。通过审查电子健康记录。我们收集了人口统计数据(年龄，sex),临床,放射学和组织病理学变量，烷化剂和放射疗法（RT）的剂量以及使用MicrosoftExcel的甲状腺疾病。数据分析采用SPSS17版，对定性数据采用Fisher精确检验，定量数据和Kaplan-Meier曲线的非参数检验。
结果：从2007年到2022年，有60例患者被诊断为HL。中位随访时间为78.5个月。有4例检测到甲状腺功能减退，5的甲状腺结节和1的亚临床甲亢。RT治疗与甲状腺功能减退症的发展显著相关（P=0.026），甲状腺结节（P=0.01）和甲状腺疾病总体（P=0.003）。我们估计甲状腺疾病的风险增加了8倍，每增加一次灰色（风险比，1.081；95%CI，1.014-1.152；P=0.017）。
结论：接受RT治疗的霍奇金淋巴瘤患者患晚期甲状腺疾病的风险增加，主要是甲状腺功能减退和恶性肿瘤。RT剂量越高，随访时间越长，这种风险越大。我们没有发现使用烷化剂与甲状腺疾病风险增加之间存在关联的证据。
方法：我们对2007年至2022年间诊断为HL的患者进行了一项观察性和回顾性研究，该研究是儿科肿瘤学参考中心。通过审查电子健康记录。我们收集了人口统计数据(年龄，sex),临床,放射学和组织病理学变量，烷化剂和放射疗法（RT）的剂量以及使用MicrosoftExcel的甲状腺疾病。数据分析采用SPSS17版，对定性数据采用Fisher精确检验，定量数据和Kaplan-Meier曲线的非参数检验。
结果：从2007年到2022年，有60例患者被诊断为HL。中位随访时间为78.5个月。有4例检测到甲状腺功能减退，5的甲状腺结节和1的亚临床甲亢。RT治疗与甲状腺功能减退症的发展显著相关（P=0.026），甲状腺结节（P=0.01）和甲状腺疾病总体（P=0.003）。我们估计甲状腺疾病的风险增加了8倍，每增加一次灰色（风险比，1.081；95%CI，1.014-1.152；P=0.017）。
结论：接受RT治疗的霍奇金淋巴瘤患者患晚期甲状腺疾病的风险增加，主要是甲状腺功能减退和恶性肿瘤。RT剂量越高，随访时间越长，这种风险越大。我们没有发现使用烷化剂与甲状腺疾病风险增加之间存在关联的证据。
