Endocrine Abstracts

Background: Neuroblastoma investigations and treatments are associated with thyroid dysfunction. This study aims to identify the consequences of different neuroblastoma investigations and treatments on the thyroid status of patients.

Methods: This is a retrospective cohort study of neuroblastoma patients at a tertiary paediatric endocrinology/oncology centre. Electronic records were reviewed for previous treatments (chemotherapy, surgery, radiotherapy, anti-GD2, IL-2), number of MIBG scans and thyroid function tests post-treatment. Out of 212 patients identified, 41 had a complete set of data. The data was analysed to understand the correlation between treatment modalities, MIBG scans, and the consequent development of hypothyroidism.

Results: 12/41 (27.9%) patients developed primary hypothyroidism. Treatment modalities included chemotherapy and surgery (n=1, 8.3%), chemotherapy (n=1, 8.3%), chemotherapy, surgery and radiotherapy (n=3, 25%), chemotherapy, radiotherapy, surgery, anti-GD2 and IL-2 (n=3, 25%) and chemotherapy, surgery, radiotherapy and anti-GD2 (n=4, 33.3%). 5/26 (19.2%) and 7/15 (46.7%) patients receiving <5 and ≥5 MIBG scans respectively developed hypothyroidism (P=0.06). 3/6 (50%) patients receiving IL-2 and 9/35 (25.7%) not receiving IL-2 developed hypothyroidism (P=0.2). 7/16(43.8%) patients on anti-GD2 and 5/25 (20%) patients not receiving anti-GD2 developed hypothyroidism (P=0.07). 5/10 (50.0%) patients received both anti-GD2 and ≥5 MIBG scans developed hypothyroidism compared to 2/6(33.3%) of those receiving anti-GD2 treatment but <5 MIBG scans and 2/5 (40.0%) receiving ≥5 MIBG scans but not anti-GD2 treatment. (P=0.80). The only patient receiving both IL-2 and ≥5 MIBG scans also developed hypothyroidism compared to 2/5 (40.0%) patients receiving IL-2 but <5 MIBG scans and 6/14 (42.9%) receiving ≥5 MIBG scans but not IL-2 treatment.

Conclusion: There was a non-statistically significant trend towards an increased frequency of post-treatment hypothyroidism in patients receiving ≥5 MIBG scans and anti-GD2 treatment in this paediatric cohort. The combination of anti-GD2 and IL-2 with higher numbers of MIBG scans did not result in a higher risk of hypothyroidism.