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Thyroid Cancer Diagnosis and Treatment / Thyroid Disorders and Treatments / Childhood Cancer Survivors' Quality of Life · Journal article
Journal of Clinical Endocrinology and Metabolism · September 9, 2026
Early or partial results. Treat as a signal, not a conclusion.
This prospective single-centre study of 286 children with newly diagnosed cancer found that overt primary hypothyroidism did not develop during treatment, but subclinical hypothyroidism and elevated reverse T3 were frequent. Although free T4 declined ≥20% in 27.7% of patients, these hormonal changes did not correlate with growth or BMI.
Prospective single-centre cohort study. 286 children diagnosed with leukemia, lymphoma, sarcoma, or brain tumor (excluding those with hypothalamic-pituitary involvement) at Princess Máxima Center.. Intervention: Systemic antineoplastic therapy for newly diagnosed cancer. n = 286. Princess Máxima Center (Netherlands, single centre).
No patient developed overt primary hypothyroidism during or after treatment Subclinical hypothyroidism present in 8.2% (18/219) at diagnosis, 2.9% (8/275) at three months, and 5.3% (9/171) post-therapy Elevated reverse T3 observed in 31.5% (46/146) at diagnosis, 46.4% (123/265) at three months, and 41% (25/61) three months post-therapy
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These results suggest that clinicians need not routinely screen for overt hypothyroidism in children during active cancer treatment, as the risk is minimal. However, subclinical abnormalities and reverse T3 elevation are common and warrant monitoring; their clinical significance and long-term implications remain unclear.
Single-centre prospective observational study with no control group measuring thyroid hormone changes during childhood cancer treatment; descriptive findings on prevalence without comparative analysis or hard clinical outcomes.
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These results suggest that clinicians need not routinely screen for overt hypothyroidism in children during active cancer treatment, as the risk is minimal. However, subclinical abnormalities and reverse T3 elevation are common and warrant monitoring; their clinical significance and long-term implications remain unclear.
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Context: Thyroid dysfunction is a well-known late effect of child cancer survivors, but its prevalence during childhood cancer treatment remains unclear.Objective: To prospectively study the prevalence of thyroid dysfunction and changes in thyroid hormone parameters during childhood cancer treatment, including its effect on height and weight.Design: Thyroid hormone parameters were prospectively collected at four time points in children with newly diagnosed cancer at the Princess Máxima Center during and shortly after systemic antineoplastic therapy.Participants: 286 children diagnosed with leukemia, lymphoma, sarcoma, or a brain tumor (not involving the hypothalamic-pituitary region) were included.Main outcomes: Prevalence of primary thyroid dysfunction and changes in thyroid function parameters.Results: None of the included patients developed overt primary hypothyroidism.Subclinical hypothyroidism was present in 8.2% (18/219) at diagnosis, in 2.9% (8/275) three months after diagnosis and in 5.3% (9/171) post-therapy.Non thyroidal illness (NTI) was found in 1.5% (4/265) of children, three months after start of treatment.However elevated concentrations of reverse T3 (rT3) were observed in 31.5% (46/146) at diagnosis, in 46.4% (123/265) at three months, and in 41% (25/61) three months posttherapy.In 27.7% (54/195) of patients, FT4 declined ≥20 % from start to three months after diagnosis and persisted until the end of therapy in 30.2% (13/43).Linear growth and BMI were unaffected by an FT4 decline ≥20%.Conclusion: Children currently treated for cancer have low risk of primary thyroid dysfunction or NTI during treatment.Although changes in thyroid hormone parameters are common, they do not seem to influence linear growth or BMI.
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