RESUMEN
The thyroid gland is often injured by supradiaphragmatic irradiation for Hodgkin's lymphoma. The aim of the present study was to examine whether the parathyroid gland gets injured by the treatment for Hodgkin's disease. Calcium, phosphorus and parathormone levels of 143 patients with primary treatment for Hodgkin's disease and in complete remission for 2 years were measured as well as the presence of antiparathyroid antibody in patients having antithyroid antibody. Out of the 143 patients studied, 104 received neck irradiation (with or without chemotherapy); among them laboratory alterations were observed in 7 cases. 39 patients received only chemotherapy; 3 of them had alterations. In contrast to the injury of the thyroid gland, no damage to the parathyroid glands associated with the treatment for Hodgkin's disease was noted. It has been concluded that the use of high-dose external radiotherapy does not mean a higher risk as regards the parathyroid gland but further follow-up studies of the patients may result in the revelation of the development of parathyroid lesions.
Asunto(s)
Enfermedad de Hodgkin/patología , Enfermedad de Hodgkin/radioterapia , Glándulas Paratiroides/patología , Glándulas Paratiroides/efectos de la radiación , Radioterapia/efectos adversos , Adolescente , Adulto , Antineoplásicos/administración & dosificación , Femenino , Estudios de Seguimiento , Enfermedad de Hodgkin/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , CuelloRESUMEN
Epidural involvement is analyzed retrospectively in 512 patients with primary treatment and follow up for Hodgkin's disease (HD) between 1970 and 1999. In one case (0.2%) epidural manifestation was the first symptom and in six cases (1.2%) it occurred later, at a disseminated, advanced stage. All seven patients were male: three had mixed cellularity and four nodular sclerosis histological subtype. The thoracic segment was involved in four cases, the lumbar in two and the cervical segment in one case. The most frequent symptoms were back pain, limb weakness, paresis/plegia, incontinence. Computer tomography, magnetic resonance imaging and myelography were used as diagnostic procedures and in planning the treatment. Functional recovery was achieved by laminectomy, loco-regional irradiation and adjuvant polychemotherapy with remission of HD for 6-100 months. Later, however, six patients died due mainly to relapse/progression of HD. We emphasize the importance of an interdisciplinary approach in the treatment of HD with this relatively rare appearance, which requires close co-operation among oncohematologists, neurologists, radiologists, neurosurgeons, radiotherapists and physiotherapists.