[Endocrine disorders after combined chemoradiotherapy in Hodgkin Lymphoma survivors].

Q4 Medicine Problemy endokrinologii Pub Date : 2023-05-11 DOI:10.14341/probl13124

M S Voytko, V V Klimontov, T I Pospelova, Y Y Shebunyaeva, O N Fazullina

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引用次数: 1

Abstract

Background: Hodgkin's lymphoma (HL) is one of the most common malignant lymphoproliferative diseases. Chemotherapy and radiotherapy used in the treatment of LH induce a number of toxic effects leading to dysfunction of endocrine system. Hormonal disorders in HL and their relationships with the therapy used remain to be clarified.

Aim: To assess disorders of the endocrine function of thyroid, parathyroid glands and gonads in HL survivors.

Materials and methods: Screening of endocrine dysfunction of the thyroid, parathyroid glands and gonads was performed in 160 adult patients with HL, 55 men and 105 women, at remission stage induced by chemotherapy or chemoradiotherapy. Forty healthy subjects, matched by age, were acted as control. The levels of TSH, T3, free T4, PTH, FSH, LH, free testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex-hormone binding globulin (SHBG) were measured in blood serum by ELISA. Bone mineral density (BMD) was assessed by DEXA.

Results: Hypothyroidism (25%), hyperparathyroidism (15.6%) and hypogonadism (29% of men and 25.3% of women) were the most prevalent endocrine disorders in LH survivors. Hypothyroidism was significantly more common in patients after chemoradiotherapy than in those who received only chemotherapy (χ2=9.4, р=0.002). In patients with hyperparathyroidism, there were negative correlations between PTH levels and BMD in the lumbar spine (r=-0.74, p=0.00002) and in the femoral neck (r=-0.66, p=0.0003). Men with HL demonstrated lower free testosterone concentrations when compared to control (p=0.04); LH and FSH levels were elevated (p=0.0004 and p=0.04, respectively). In men with HL the levels of DHEA-S were reduced (p=0.0009). The increased SHBG concentrations were revealed in 13 (23.6%) men. Women of reproductive age with HL had higher levels of LH in the luteal phase (p=0.05) and FSH in the follicular phase (p=0.02) than controls.

Conclusion: The data indicate a high prevalence of the dysfunctions of thyroid, parathyroid glands, and gonads in HL survivors. Screening for endocrine disorders in these patients is highly recommended.

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[霍奇金淋巴瘤幸存者联合放化疗后内分泌紊乱]。

背景:霍奇金淋巴瘤(Hodgkin’s lymphoma, HL)是最常见的恶性淋巴细胞增生性疾病之一。黄体生成素的化疗和放疗可引起多种毒性作用，导致内分泌系统功能紊乱。HL患者的激素紊乱及其与所使用治疗的关系仍有待澄清。目的:探讨HL患者甲状腺、甲状旁腺和性腺内分泌功能紊乱情况。材料与方法:对160例经化疗或放化疗缓解期的成年HL患者(男55例，女105例)进行甲状腺、甲状旁腺及性腺内分泌功能障碍筛查。40名按年龄匹配的健康受试者作为对照。采用ELISA法测定血清TSH、T3、游离T4、PTH、FSH、LH、游离睾酮、硫酸脱氢表雄酮(DHEA-S)、性激素结合球蛋白(SHBG)水平。DEXA测定骨密度(BMD)。结果:甲状腺功能减退(25%)、甲状旁腺功能亢进(15.6%)和性腺功能减退(29%的男性和25.3%的女性)是LH幸存者中最常见的内分泌疾病。放化疗后甲减发生率明显高于单纯化疗组(χ2=9.4， χ2= 0.002)。甲状旁腺功能亢进症患者PTH水平与腰椎(r=-0.74, p=0.00002)和股骨颈(r=-0.66, p=0.0003)骨密度呈负相关。与对照组相比，HL患者的游离睾酮浓度较低(p=0.04);LH和FSH水平升高(p=0.0004和p=0.04)。在HL患者中，DHEA-S水平降低(p=0.0009)。13例(23.6%)男性出现SHBG浓度升高。育龄HL患者黄体期LH (p=0.05)和卵泡期FSH (p=0.02)水平均高于对照组。结论:数据表明，在HL幸存者中，甲状腺、甲状旁腺和性腺功能障碍的患病率很高。强烈建议对这些患者进行内分泌紊乱筛查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Problemy endokrinologii Medicine-Endocrinology, Diabetes and Metabolism

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1.40

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0.00%

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期刊介绍： Since 1955 the “Problems of Endocrinology” (or “Problemy Endocrinologii”) Journal publishes timely articles, balancing both clinical and experimental research, case reports, reviews and lectures on pressing problems of endocrinology. The Journal is aimed to the most topical issues of endocrinology: to chemical structure, biosynthesis and metabolism of hormones, the mechanism of their action at cellular and molecular level; pathogenesis and to clinic of the endocrine diseases, new methods of their diagnostics and treatment. The Journal: features original national and foreign research articles, reflecting world endocrinology development; issues thematic editions on specific areas; publishes chronicle of major international congress sessions and workshops on endocrinology, as well as state-of-the-art guidelines; is intended for scientists, endocrinologists diabetologists and specialists of allied trade, general practitioners, family physicians and pediatrics.