Stella Ling1, Aashish D Bhatt1, Nicole V Brown2, Phuong Nguyen1, Jennifer A Sipos3, Arnab Chakravarti1, Yi Rong1,4. 1. Department of Radiation Oncology, The Ohio State University, Columbus, Ohio. 2. Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio. 3. Department of Endocrinology, The Ohio State University, Columbus, Ohio. 4. Department of Radiation Oncology, University of California - Davis Comprehensive Cancer Center, Sacramento, California.
Abstract
BACKGROUND: Thyroid dysfunction is common after radiotherapy (RT) for patients with head and neck cancers. We attempted to discover RT dose parameters that correspond with RT-induced thyroid dysfunction. METHODS: Records of 102 patients who received RT from 2008 to 2010 were reviewed with respect to thyroid function. Abnormalities were grouped in 2 ways: (1) none, transient, or permanent; and (2) overt or subclinical. RESULTS: At median follow-up of 33.5 months, incidence of any thyroid abnormality was 39.2% (women vs men - 50% vs 35%). Permanent dysfunction was seen in 24.5% with higher incidence in women versus men (42.9% vs 17.6%; p = .0081). Permanent abnormalities most strongly correlated with D50% (p = .0275). V50Gy also correlated with thyroid dysfunction post-RT (p = .0316). Concurrent chemotherapy increased permanent dysfunction (p = .0008). CONCLUSION: Achieving D50% <50 Gy, V50 <50%, and mean dose <54.58 Gy during RT planning may decrease the incidence; whereas female sex and concurrent chemotherapy seem to increase the risk of RT-induced hypothyroidism.
BACKGROUND:Thyroid dysfunction is common after radiotherapy (RT) for patients with head and neck cancers. We attempted to discover RT dose parameters that correspond with RT-induced thyroid dysfunction. METHODS: Records of 102 patients who received RT from 2008 to 2010 were reviewed with respect to thyroid function. Abnormalities were grouped in 2 ways: (1) none, transient, or permanent; and (2) overt or subclinical. RESULTS: At median follow-up of 33.5 months, incidence of any thyroid abnormality was 39.2% (women vs men - 50% vs 35%). Permanent dysfunction was seen in 24.5% with higher incidence in women versus men (42.9% vs 17.6%; p = .0081). Permanent abnormalities most strongly correlated with D50% (p = .0275). V50Gy also correlated with thyroid dysfunction post-RT (p = .0316). Concurrent chemotherapy increased permanent dysfunction (p = .0008). CONCLUSION: Achieving D50% <50 Gy, V50 <50%, and mean dose <54.58 Gy during RT planning may decrease the incidence; whereas female sex and concurrent chemotherapy seem to increase the risk of RT-induced hypothyroidism.
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