Hypothyroidism as a Consequence of Intensity-Modulated Radiotherapy With Concurrent Taxane-Based Chemotherapy for Locally Advanced Head-and-Neck Cancer

Díaz, Roberto; Jaboin, Jerry J.; Morales-Paliza, Manuel; Koehler, Elizabeth; Phillips, John G.; Stinson, Scott; Gilbert, Jill; Chung, Christine H.; Murphy, Barbara A.; Yarbrough, Wendell G.; Murphy, Patrick; Shyr, Yu; Cmelak, Anthony J.

doi:10.1016/j.ijrobp.2009.05.018

Cited by 92 publications

(102 citation statements)

References 41 publications

(86 reference statements)

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“…However, use of dose-volumetric parameters for post-RT HT has not been clearly identified and has inconsistent results. [3,5,18,19] Our result show that if the mean radiation dose received by the thyroid increases, it is a significant risk factor for post-RT HT, and this risk starts after 20 Gy. On the other hand, the mean radiation dose of the primary tumor site was 66 Gy and there was no statistically significant effect of post-RT, similar with the literature.…”

Section: Discussionmentioning

confidence: 58%

“…On the other hand, the mean radiation dose of the primary tumor site was 66 Gy and there was no statistically significant effect of post-RT, similar with the literature. [3,5,14,19] There is also a debate about the correlation of age, sex, thyroid volume, neck dissection before RT, primary tumor site, and stage. For instance, some studies indicate a higher incidence of HT among female patients [1,7,20] whereas other studies show no impact on the likelihood of developing HT on the basis of sex.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, some studies indicate a higher incidence of HT among female patients [1,7,20] whereas other studies show no impact on the likelihood of developing HT on the basis of sex. [13,17,[21][22][23] Diaz et al [19] reported that smaller thyroid volume had an increased risk factor for post-RT HT. Moreover, Alterio et al [7] reported that women's thyroid glands were less affected by RT as they were smaller than men's.…”

Section: Discussionmentioning

confidence: 99%

“…However, when we grouped the patients according to age above and below 60 years, we found that younger age was a significant risk fac-tor for post-RT HT, as with other studies in the literature. [13,19,20] The increased efficacy of RT in younger patients who have a more mitotic activity may explain the greater incidence of HT in this group (<60 years). [24] However, the effect of age has been disproved by many researchers.…”

Section: Discussionmentioning

confidence: 99%

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Post-radiotherapy hypothyroidism in head and neck cancers: When should we be concerned?

Çelık¹

2017

Kulak Burun Bogaz Ihtis Derg

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Objectives:This study aims to analyze the incidence of hypothyroidism (HT) in patients who underwent radiotherapy (RT) for head and neck cancers (HNC), and to determine risk factors. Patients and Methods:This study was a retrospective analysis of patients who were treated with RT alone or in combination with surgery and/or chemotherapy between January 2005 and May 2012. Patients were grouped according to the primary tumor site, TNM staging system, age, gender, total radiation dose (TRD), mean radiation dose of thyroid gland (MRT), neck dissection, and chemotherapy.Results: A total of 90 patients who were treated with RT were analyzed. The median age was 52±13 (range, 12-87) years. The histopathologic finding of 88 patients was squamous cell carcinoma, others were adenocystic carcinoma and undifferentiated carcinoma. The median follow-up of all patients after RT was 15 (range, 6-72) months. Post-radiotherapy HT was found in 31 patients (34.4%). In this group, clinical and subclinical HT was present in eight (26%) and 23 (74%) patients, respectively. Age younger than 60 years and increased MRT (especially mean thyroid dose 20 Gy<) were significant risk factors for post-radiotherapy HT (p<0.05). Conclusion:Physicians should pay more attention to HT in patients who were treated with RT for HNC during follow-up.Keywords: Head and neck cancers; hypothyroidism; mean radiation dose of thyroid gland; radiotherapy; thyroid gland. Sonuç: Hekimler, takip sırasında HNC için RT ile tedavi edilen hastalarda HT'ye daha fazla dikkat etmelidirler.Anahtar Sözcükler: Baş ve boyun kanserleri; hipotiroidizm; tiroid bezinin ortalama radyasyon dozu; radyoterapi; tiroid bezi.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Post-radiotherapy hypothyroidism in head and neck cancers: When should we be concerned?

Çelık¹

2017

Kulak Burun Bogaz Ihtis Derg

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“…1,9,26,30,31 Nomeadamente, Bhandare et al, encontraram uma diferença significativa na incidência de hipotiroidismo, quando compararam os doentes que receberam uma dose média na glândula tiroideia superior ou igual a 45 Gy com aqueles que receberam uma dose média inferior a este valor. 8 No primeiro grupo verificou-se uma incidência significativamente superior de hipotiroidismo (27% aos cinco anos e 39% aos dez anos), comparativamente aos doentes que receberam uma dose média inferior a 45 Gy (21% aos cinco e aos dez anos).…”

Section: 2423-29unclassified

Hipotiroidismo Secundário à Irradiação Cervical: Avaliação Sistemática da Função Tiroideia no Seguimento

et al. 2014

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Em 51,9% dos doentes foi efetuado o diagnóstico de hipotiroidismo entre os 9 e os 12 meses após o tratamento de radioterapia. Discussão: Da análise da literatura publicada, o hipotiroidismo constitui a complicação tiroideia radioinduzida mais frequente e afeta uma grande percentagem de doentes submetidos a radioterapia cervical com intenção curativa. Foi demonstrado que o risco de hipotiroidismo aumenta com o tempo após a exposição, contudo a incidência mais elevada parece ser nos dois primeiros anos após o tratamento. Da nossa análise obtivemos, aos 12 meses uma taxa de incidência global de hipotiroidismo de 18,6%, (grau 1 de 16,55% e grau 2 de 2,1%). Conclusão: Neste estudo foi encontrada uma incidência de hipotiroidismo correspondente aos valores mais baixos descritos em outros estudos publicados. O curto tempo de follow-up considerado nesta análise poderá justificar os resultados obtidos. Face aos resultados obtidos, e correlacionando-os com a literatura disponível, os autores consideram justificável e recomendável a inserção da avaliação sistemática da função tiroideia no protocolo de follow-up destes doentes. Palavras-chave: Neoplasias da Cabeça e Pescoço; Radioterapia; Hipotiroidismo; Estudos de Seguimento.

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Effect of dose constraint on the thyroid gland during locoregional intensity‐modulated radiotherapy in breast cancer patients

Haciislamoglu

Canyılmaz

Gedik³

et al. 2019

J Applied Clin Med Phys

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The aim of the present study was to compare radiation dose received by thyroid gland using different radiotherapy (RT) techniques with or without thyroid dose constraint (DC) for breast cancer patients. Computerized tomography (CT) image sets for 10 patients with breast cancer were selected. All patients were treated originally with opposite tangential field‐in field (FinF) for the chest wall and anteroposterior fields for the ipsilateral supraclavicular field. The thyroid gland was not contoured on the CT images at the time of the original scheduled treatment. Four new treatment plans were created for each patient, including intensity‐modulated radiotherapy (IMRT) and helical tomotherapy (HT) plans with thyroid DC exclusion and inclusion (IMRTDC(−), IMRTDC(+), HTDC(−), and HTDC(+), respectively). Thyroid DCs were used to create acceptable dose limits to avoid hypothyroidism as follows: percentage of thyroid volume exceeding 30 Gy less than 50% (V30 < 50%) and mean dose of thyroid (TDmean) ≤ 21 Gy. Dose‐volume histograms (DVHs) for TDmean and percentages of thyroid volume exceeding 10, 20, 30, 40, and 50 Gy (V10, V20, V30, V40, and V50, respectively) were also analyzed. The Dmean of the FinF, IMRTDC(−), HTDC(−), IMRTDC(+) and HTDC(+) plans were 30.56 ± 5.38 Gy, 25.56 ± 6.66 Gy, 27.48 ± 4.16 Gy, 18.57 ± 2.14 Gy, and 17.34 ± 2.70 Gy, respectively. Median V30 values were 55%, 33%, 36%, 18%, and 17%, for FinF, IMRTDC(−), HTDC(−), IMRTDC(+), and HTDC(+), respectively. Differences between treatment plans with or without DC with respect to Dmean and V30 values were statistically significant (P < 0.05). When thyroid DC during breast cancer RT was applied to IMRT and HT, the TDmean and V30 values significantly decreased. Therefore, recognition of the thyroid as an organ at risk (OAR) and the use of DCs during IMRT and HT planning to minimize radiation dose and thyroid volume exposure are recommended.

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Hypothyroidism as a Consequence of Intensity-Modulated Radiotherapy With Concurrent Taxane-Based Chemotherapy for Locally Advanced Head-and-Neck Cancer

Cited by 92 publications

References 41 publications

Post-radiotherapy hypothyroidism in head and neck cancers: When should we be concerned?

Post-radiotherapy hypothyroidism in head and neck cancers: When should we be concerned?

Hipotiroidismo Secundário à Irradiação Cervical: Avaliação Sistemática da Função Tiroideia no Seguimento

Effect of dose constraint on the thyroid gland during locoregional intensity‐modulated radiotherapy in breast cancer patients

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