Pediatric brain tumors: radiation tied to drop in free thyroxine levels

  • van Iersel L & al.
  • J Clin Endocrinol Metab
  • 07.06.2019

  • von Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Radiotherapy (RT) is associated with decreased levels of free thyroxine (FT4) in pediatric/adolescent patients with brain tumors, which might affect weight gain and intelligence scores.

Why this matters

  • Study clarifies trends and clinical significance of FT4 concentration in children and adolescents with low-grade glioma or ependymoma.

Key results

  • FT4 levels decreased over time after RT (−0.00097 ng/dL per month; P<.001>
  • Female sex (P<.001 and younger age were associated with greater reductions in ft4 levels multivariate analysis.>
  • FT4 decline rate was associated with a greater rate of weight gain (P<.001>
  • Lower baseline FT4 was associated with increased risk for glucose disorder (OR, 19.73; P=.002) and dyslipidemia (OR, 19.40; P=.003), but decline in FT4 after RT was not.
  • Although intelligence scores improved over time, the rate of improvement was lower in patients with higher rates of FT4 decline (P=.014).

Study design

  • 267 patients aged ≤25 years with low-grade glioma or ependymoma who were treated with RT were analyzed for FT4 levels.
  • Funding: Royal Netherlands Academy of Arts and Sciences and Stichting Kinderen Kankervrij; American Lebanese Associated Charities.

Limitations

  • Observational study design.