Incidence of thyroid dysfunction post radiotherapy in head and neck cancer
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20252987Keywords:
Hypothyroidism, Head and neck cancer, Thyroid function testAbstract
Background: Globally, head and neck cancer rank sixth in terms of incidence with squamous cell carcinoma being the most common. In case of early-staged cancer (T1 or T2), it is treated with a single modality of treatment, such as radiation therapy or surgery. In locally advanced head and neck cancer, it is treated with radiotherapy with or without chemotherapy. Primary hypothyroidism is indicated to be in between 11-53%. Aim is to estimate the incidence of thyroid dysfunction post radiotherapy in head and neck cancer.
Methods: This is a prospective and observational study done in a tertiary care centre over a period of 1 year in 66 patients. Written and informed consent was taken, data was collected in a predesigned questionnaire and baseline blood tests was done prior, 3rd and 6th month post radiotherapy.
Results: The incidence of hypothyroidism in our study was 15.15% with maximum incidence was found in Ca larynx (29.16%) followed by Ca hypopharynx (22.22%). 15.5% hypothyroid patients were treated with concurrent radiotherapy whereas 12.5% were not.
Conclusions: Hypothyroidism incidence increases with time, where majority develop after 6 months post-radiotherapy. Age, sex and concurrent chemotherapy were not identified as relevant risk factors in our study. Smaller sample size, shorter time period and single centre based were the limitations of the study.
Metrics
References
Shewalkar BK, Balachandran R, Pant P, Patel J. A prospective clinical study to assess primary hypothyroidism in head and neck cancer patients treated with external beam radiotherapy. J Cancer Res Ther. 2023;19(2):530-5. DOI: https://doi.org/10.4103/jcrt.jcrt_934_22
Scott-Brown WG. Scott-Brown's Otorhinolaryngology, Head and Neck Surgery. Hodder Education. 2008.
Chow JCH, Cheung KM, Cheung GTC, Tam AHP, Lui JCF, Lee FKH, et al. Dose-volume predictors of post-radiation primary hypothyroidism in head and neck cancer: A systematic review. Clin Transl Radiat Oncol. 2022;33:83-92. DOI: https://doi.org/10.1016/j.ctro.2022.01.001
Kim MY, Yu T, Wu HG. Dose-volumetric parameters for predicting hypothyroidism after radiotherapy for head and neck cancer. Japanese J Clin Oncol. 2014;44(4):331-7. DOI: https://doi.org/10.1093/jjco/hyt235
Srikantia N, Rishi KS, Janaki MG, Bilimagga RS, Ponni A, Rajeev AG, et al. How common is hypothyroidism after external radiotherapy to neck in head and neck cancer patients? Indian J Med Paediatr Oncol. 2011;32(3):143-8. DOI: https://doi.org/10.4103/0971-5851.92813
Pil J, Nevens D, Van der Vorst A, Gadan C, Nuyts S. The incidence of hypothyroidism after radiotherapy for head and neck cancer. B-ENT. 2016;12(4):257-62.
Luo R, Wu VWC, He B. Development of a normal tissue complication probability (NTCP) model for radiation-induced hypothyroidism in nasopharyngeal carcinoma patients. BMC Cancer. 2018;18:575. DOI: https://doi.org/10.1186/s12885-018-4348-z
Fujiwara M, Kamikonya N, Odawara S, Suzuki H, Niwa Y, Takada Y, et al. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases. J Radiat Res. 2015;56(3):577-82. DOI: https://doi.org/10.1093/jrr/rrv006
Huang CL, Tan HW, Guo R, Zhang Y, Peng H, Peng L, et al. Thyroid dose-volume thresholds for the risk of radiation-related hypothyroidism in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy-a single-institution study. Cancer Med. 2019;8(16):6887-93. DOI: https://doi.org/10.1002/cam4.2574
Zhai RP, Kong FF, Du CR, Hu CS, Ying HM. Radiation-induced hypothyroidism after IMRT for nasopharyngeal carcinoma: Clinical and dosimetric predictors in a prospective cohort study. Oral Oncol. 2017;68:44-9. DOI: https://doi.org/10.1016/j.oraloncology.2017.03.005
Downloads
Published
How to Cite
Issue
Section
