{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T15:32:42Z","timestamp":1793287962407,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ministero della Salute","award":["no available"],"award-info":[{"award-number":["no available"]}],"id":[{"id":"https:\/\/ror.org\/00789fa95","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Multimodal treatment, including both conventional and myeloablative chemotherapy (MAT), radiotherapy, surgery, immunotherapy, and differentiating therapy, has increased survival for children affected by high-risk neuroblastoma (HRNB) at the potential cost of long-term endocrine morbidities. In this retrospective single-center study we investigate the long-term thyroid toxicity in neuroblastoma survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective, single-center cohort study. HRNB survivors were followed in outpatient clinic with a scheduled long-term follow-up program; for this report, we considered patients alive on June 1, 2023 at least 5 years from diagnosis treated during 1996\u20132018 period. Data were obtained from a chart review and were evaluated as risk factors for long-term toxicity occurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-five patients with a median follow-up from diagnosis of 10.6 years (range 5\u201325.8 years) were evaluated. Long-term thyroid toxicities were reported in 24\/45 (53%) patients at a median time of 7.5 years (range 1.2\u201318.2; interquartile range 3\u201312) from diagnosis; hypothyroidism was the most common toxicity (12\/24, 50% of patients). The probability of being free from thyroid toxicity at 10 years was 62% (CI: 44\u201375%). Analyzing children\u2019s exposure to different treatments, the probability was 0% in patients who have undergone molecular radiotherapy and 72% (CI: 53\u201385%) in those who did not (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001); 30% (CI: 6\u201359%) in those who received immunotherapy and 78% (CI: 65\u201390%) in those who did not (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008); 37% (CI: 12\u201364%) in patients treated with tandem MAT and 71% (CI: 49\u201385%) in children who underwent single MAT (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.016); and 86% in patients who did not receive Busulfan (CI: 39\u201398%) and 55% (CI: 35\u201371%) in those who did receive Busulfan (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002). Patients undergoing immunotherapy,\n                      <jats:sup>131<\/jats:sup>\n                      I-meta-iodobenzylguanidine therapy or Busulfan experienced thyroid toxicity significantly earlier than those who did not (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The high cumulative treatment burden in this population results in a substantial risk of thyroid toxicity, even many years after therapy. Therefore, long-term endocrine follow-up should be considered also during adulthood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256261425684","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T04:25:48Z","timestamp":1771993548000},"page":"259-267","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Thyroid Toxicity Burden in Children Who Received Treatment for High-Risk Neuroblastoma"],"prefix":"10.1177","volume":"36","author":[{"given":"Annalisa","family":"Deodati","sequence":"first","affiliation":[{"name":"Endocrinology and Diabetes Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."},{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Fabozzi","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Mirra","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giuseppina","family":"Cefalo","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Del Bufalo","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"D\u2019Antonio","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Grossi","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Pampanini","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Pizzoferro","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Serra","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziamaria","family":"Ubertini","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Mastronuzzi","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Cianfarani","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."},{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Locatelli","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, Italy."},{"name":"Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonietta","family":"De Ioris","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Cell and Gene Therapy, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Rome, 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