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Cited by 16

The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.

Clinical Importance of Free Thyroxine Concentration Decline After Radiotherapy for Pediatric and Adolescent Brain Tumors

van Iersel, Laura, Xu, Jiahui, Potter, Brian S, Conklin, Heather M, Zhang, Hui, Chemaitilly, Wassim, van Santen, Hanneke M, Merchant, Thomas E·2019·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2019-00539
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Abstract

Context: Clinical significance of a decline in free T4 (FT4) concentrations across the reference range in children with brain tumors treated with radiation therapy (RT) is uncertain. Objectives: To study trends in FT4 in children after RT and risk factors and health outcomes associated with plasma FT4 concentrations. Design and Setting: Longitudinal, single-center retrospective cohort study. Patients: Low-grade glioma or ependymoma patients (n = 267; age ≤25 years) who received RT (50.4 to 59.4 Gy) at a single institution (1996 to 2016) and followed with serial FT4 measurements. Main Outcome Measure: A linear mixed-effects model with a random intercept was used to investigate risk factors for longitudinal changes in FT4 concentrations. A two-stage mixed-effects model examined associations between clinical outcomes and plasma FT4 concentrations. Results: FT4 concentrations declined over time after RT (P < 0.001). Females (P < 0.001) and younger patients (P < 0.001) demonstrated greater declines in FT4 concentrations over time. The rate of weight gain, but not of height loss, increased with a higher FT4 decline rate (P < 0.001). At last follow-up, patients with lower baseline FT4 concentrations had increased risk of glucose disorder (OR, 19.73; P = 0.002) or dyslipidemia (OR, 19.40; P = 0.003) but not high fat mass (P = 0.18). Lower baseline FT4 concentrations were not associated with impaired scores for intelligence, attention, memory, or psychosocial functioning. Conclusions: FT4 concentrations significantly decline in children with brain tumor after RT. Variation and trends in FT4 concentration are associated with physical health outcomes. Future studies should assess whether continuous FT4 concentrations and trends, rather than population-based cut-off values, can distinguish between euthyroid and hypothyroid states.

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Research works printed but not linked: 19

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  2. Laughton, 2008, Endocrine outcomes for children with embryonal brain tumors after risk-adapted craniospinal and conformal primary-site irradiation and high-dose chemotherapy with stem-cell rescue on the SJMB-96 trial, J Clin Oncol, 26, 1112, 10.1200/JCO.2008.13.5293 · DOI
  3. Brabant, 2012, Hypothyroidism following childhood cancer therapy–an under diagnosed complication, Int J Cancer, 130, 1145, 10.1002/ijc.26086 · DOI
  4. Doin, 2012, Diagnosis of subclinical central hypothyroidism in patients with hypothalamic–pituitary disease by Doppler echocardiography, Eur J Endocrinol, 166, 631, 10.1530/EJE-11-0907 · DOI · Paper page
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  8. van Iersel, 2018, Declining free thyroxine levels over time in irradiated childhood brain tumor survivors, Endocr Connect., 7, 1322, 10.1530/EC-18-0311 · DOI · Paper page
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  15. Vatner, 2018, Endocrine deficiency as a function of radiation dose to the hypothalamus and pituitary in pediatric and young adult patients with brain tumors, J Clin Oncol, 36, 2854, 10.1200/JCO.2018.78.1492 · DOI
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Cited by

Metadata

Authors
van Iersel, L., Xu, J., Potter, B. S., Conklin, H. M., Zhang, H., Chemaitilly, W., van Santen, H. M., & Merchant, T. E.
Affiliations
  • Division of Endocrinology, St. Jude Children’s Research Hospital, Memphis, Tennessee
  • Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
  • Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
  • Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, EA Utrecht, Netherlands
  • Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2019-06-07
Volume
104
Issue
11
Pages
4998-5007
ISSN
  • 0021-972X
  • 1945-7197
DOI
10.1210/jc.2019-00539
Cited by
16
References
12
Language
en
Funders
  • Ter Meulen Grant (TMB17316)
  • Stichting Kinderen Kankervrij (282)
  • American Lebanese and Syrian Associated Charities

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