医学
放射治疗
亚临床感染
甲状腺
入射(几何)
喉
头颈部癌
前瞻性队列研究
随机对照试验
核医学
肿瘤科
泌尿科
内科学
外科
光学
物理
作者
Vedang Murthy,Kushal Narang,Sarbani Ghosh‐Laskar,Tejpal Gupta,Ashwini Budrukkar,J. P. Agrawal
出处
期刊:Head & neck
[Wiley]
日期:2014-03-17
卷期号:36 (11): 1573-1580
被引量:45
摘要
Abstract Background The purpose of this study was to determine the incidence of hypothyroidism after chemoradiation in head and neck squamous cell cancer (HNSCC). Methods One hundred twenty‐two patients treated with 3‐dimensional conformal radiotherapy (3DCRT; 70 Gy/35#) or intensity‐modulated radiation therapy (IMRT; 66 Gy/30#) in 2 identical simultaneous randomized trials were studied. Thyroid function was assessed at baseline and every 3 to 6 monthly thereafter. Development of subclinical (thyroid‐stimulating hormone [TSH] >4.67 μIU/mL) or biochemical (T4 <4.5 μg/dL) hypothyroidism was noted. Multivariate analyses were done to determine the factors associated with hypothyroidism. Results At a median of 41 months, 55.1% of the patients developed hypothyroidism (39.3% subclinical, 15.7% biochemical). The IMRT arm had higher subclinical hypothyroidism (51.1% vs 27.3%; p = .021) peaking around 1 year postradiotherapy in both arms. Younger age, hypopharynx/larynx primary, node positivity, higher dose/fraction (IMRT arm), and D100 were statistically significant factors for developing hypothyroidism. Conclusion Postradiotherapy hypothyroidism peaks at 1 year. Higher dose per fraction possibly led to greater incidence of hypothyroidism in the IMRT cohort. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1573–1580, 2014
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