Hypothyroidism After Treatment for Nonthyroid Head and Neck Cancer

Sinard, Robert J.; Tobin, Evan J.; Mazzaferri, Ernest L.; Hodgson, Sheila E.; Young, Donn C.; Kunz, Annie L.; Malhotra, Pramit S.; Fritz, Michael A.; Schuller, David E.

doi:10.1001/archotol.126.5.652

Cited by 120 publications

(119 citation statements)

References 20 publications

(24 reference statements)

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“…Posner et al 7,9 examined the effect of combination chemotherapy on hypothyroidism in patients with head and neck carcinoma and found no association. Similarly, Weissler and Berry 25 and Sinard et al 26 reported no increase in the incidence of hypothyroidism in patients with head and neck carcinoma who were treated with chemotherapy, an observation that was confirmed in our series. However, Hancock et al 23 reported that chemotherapy was a significant risk factor for the development of hypothyroidism after radiation therapy in patients with Hodgkin disease.…”

Section: Discussionsupporting

confidence: 89%

Hypothyroidism

Mercado

Adelstein

Saxton

et al. 2001

Cancer

143

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The use of an internal circulating fluidized bed (ICFB) is proposed for the oxidative dehydrogenation of butane. The reactor consists of two adjacent zones, separated by a wall. In the oxidizing zone the catalyst is oxidized and in the reducing zone the butane is dehydrogenated by reaction with the oxygen from the catalyst lattice. The circulation between both zones is produced by the different bed porosity, which originates a pressure difference between the two zones at the communication orifice at the bottom of the vessel. The design of this reactor is studied in a cold model. An image analysis technique was applied to measure solid circulation rates between the different regions in the reactor, by using a solid coated with a long afterglow phosphor as a tracer. The solid circulation rates through the orifices were found to correlate reasonably well with a previously developed correlation for the orifice drag coefficient. The model for solid circulation between fluidized regions was then integrated in the overall mathematical model for the ICFB reactor system to incorporate the effect of design and operating conditions on the catalyst circulation rates between compartments. A good correlation between the experimentally obtained values of conversion and selectivity and those predicted by the model is obtained. Improvements in selectivity to olefins are obtained, compared with conventional fluidized‐bed reactors with cofeeding of reactants. © 2004 American Institute of Chemical Engineers AIChE J, 50: 1510–1522, 2004

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Section: Discussionsupporting

confidence: 89%

Hypothyroidism

Mercado

Adelstein

Saxton

et al. 2001

Cancer

143

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“…The frequency of autoimmune thyroid diseases, including Hashimoto's thyroiditis [16,17], Graves' disease [3][4][5][6] and Graves' ophthalmopathy [4], in patients who have received external radiation therapy is significantly higher than that in untreated controls. Indeed, patients who have received external radiation to the cervical region are more likely to have antithyroid antibodies than are untreated patients [17], and the titers of antithyroid antibodies are elevated after radiation therapy [18]. In our case, various autoimmune antibodies, including TSAb, TgAb and TPOAb, were detected at the onset of Graves' ophthalmopathy.…”

Section: Discussionmentioning

confidence: 57%

A Case of Hypothyroid Graves' Disease Following External Radiation Therapy to the Cervical Region

et al. 2006

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Abstract. A case of hypothyroid Graves' disease occurred following external radiation therapy to the cervical region is described. Severe hypothyroidism developed in a 56-year-old man 6 months after external radiation therapy for submandibular cancer. Serological evaluation of thyroid autoimmunity revealed the presence of antithyroid antibodies and thyrotropin-binding inhibitory immunogloblins (TBII). Diplopia, limitation of downward gaze, and palpebral edema developed 2 years after levothyroxine replacement therapy. Ocular magnetic resonance imaging revealed marked hypertrophy of the bilateral extraocular muscles with signal hyperintensity on T2-weighted images. This infiltrative ophthalmopathy showed marked improvement after additional treatment with high-dose methylprednisolone and orbital radiation, in parallel with a decrease in TBII. These results suggest that radiation-associated thyroidal injury might be associated with the etiology of hypothyroid Graves' disease.

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“…It rises to 28% when accompanied with surgery and 35-65% when associated with hemithyroidectomy. [13][14][15] The incidence in those who undergo total laryngectomy with ipsilateral hemithyoidectomy, is around 44-89%. [16][17][18][19][20] This is due to surgical manipulation or radiation therapy causing disruption of gland vascularity or immune mediated response to radiotherapy as evidenced by the elevated levels of anti thyroglobin and or antimicrosomal antibody titres.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19][20] This is due to surgical manipulation or radiation therapy causing disruption of gland vascularity or immune mediated response to radiotherapy as evidenced by the elevated levels of anti thyroglobin and or antimicrosomal antibody titres. 13 The time of onset of hypothyroidism in post treated T4 hypopharyngeal and laryngeal cancers is 42 days versus 110 days in salvage and primary cases respectively.…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers

Janardhan

Varghese

Iype

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Total laryngectomy in laryngohypopharyngeal cancers, both in primary setting and salvage scenario, include variable amounts of thyroid resection. Although considerable proportion of these cases undergo total thyroidectomy, with an intention of wider surgical clearance, histopathological examination for thyroid infiltration, very often indicate that such resections are generally out of proportion to the actual oncological requirement.Methods: Forty three patients undergoing total laryngectomy with no prior thyroid dysfunction, from April 2014 to 2016, at our centre, were prospectively studied for post treatment, thyroid function with tests done at 6th month. Overt and occult hypothyroidism was correlated with extent of thyroid preserved intraoperatively. Results: Of 43 patients studied, 82% had extralaryngeal spread, and 16% of them showed thyroid gland infiltration. Only 7% were patholog1ically correlated for gland infiltration. Among those who had hemithyroidectomy, clinical hypothyroidism was seen in 20% primary and 85% salvage cases by 6th month of post treatment period.Conclusions: In clinicoradiologically favourable scenarios, thyroid preservation attempt helps to augment the neopharynx closure line and to preserve the parathyroids. Anatomical preservation however doesnot guarantee thyroid function, which needs regular follow up to avoid post-operative complications and better QOL.

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Hypothyroidism After Treatment for Nonthyroid Head and Neck Cancer

Abstract: Approximately 15% of patients treated for advanced head and neck cancer with surgery and radiotherapy will develop hypothyroidism. Those treated with total laryngectomy and radiotherapy are at greatest risk.

Cited by 120 publications

References 20 publications

Hypothyroidism

Hypothyroidism

A Case of Hypothyroid Graves' Disease Following External Radiation Therapy to the Cervical Region

Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers

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