Radiation-Induced Hypothyroidism After Radical Intensity Modulated Radiation Therapy for Oropharyngeal Carcinoma

Kamal, Mona; Peeler, C; Mohamed, A.S.R.; Blanchard, Pierre; Frank, Steven J.; Chen, Lei; Jethanandani, Amit; Kuruvilla, Rohit; Greiner, Ben; Harp, J.; Granberry, R.; Mehta, Vivek; Rock, Crosby D.; Hutcheson, Katherine A.; Cárdenas, Carlos; Gunn, G. Brandon; Fuller, Clifton D.; Mirković, Dragan

doi:10.1016/j.adro.2019.08.006

Cited by 16 publications

(19 citation statements)

References 37 publications

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“…Our results have shown that the incidence of RIHT after maximum follow up of 24 months was 26%. The range of reported incidence from similar studies ranged from 17-47% [2,5,15,16,18,19]. Our follow up period is relatively short and the incidence is expected to increase with longer follow up periods.…”

Section: Discussionmentioning

confidence: 83%

“…Various authors have conducted similar studies on patients who have the same cancer type like nasopharyngeal carcinoma [13], laryngeal carcinoma [14] or oropharyngeal carcinoma [2]. Other authors have studied the same topic on cohorts with variable malignancies [3,15].…”

Section: Discussionmentioning

confidence: 99%

“…Other authors have defined V 30 > 62.6% [19], V 30 > 42.1% [16], D 50 of 44 Gy [27], V 50 > 60% [20] as the threshold for RIHT. Mean dose ≥ 50 Gy was considered a considerable cutoff [2]. This wide range of cutoff predictors can be explained with varying methodology.…”

Section: Discussionmentioning

confidence: 99%

“…Radiation induced hypothyroidism (RIHT) is the most common late effect of radiation to the thyroid gland, commonly in head and neck cancer. Recent reports state the incidence of RIHT to be between 17-47.7% [1][2][3]. The median interval after radiotherapy until RIHT development ranged from 1.4 to 1.8 years [4].…”

Section: Introductionmentioning

confidence: 99%

“…The positive predictors for risk factors related to dose-volume relationship for the thyroid gland have been unclear despite various reports about various risk factors. The application of 3D conformal radiotherapy (3DCRT) now enables us to measure the volume and the dose delivered to this volume of the thyroid gland and to correlate the dose-volume relationship with RIHT after external beam radiotherapy (EBRT) [2].…”

Section: Introductionmentioning

confidence: 99%

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Dose-volumetric Predictors for Thyroid Dysfunction after 3D Conformal Radiotherapy: An Observational, Prospective Study

AlJamal

El-Naby

El‐Badrawy

et al. 2020

JCTI

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Aim: This study was conducted to assess the dose-volumetric threshold of radiation induced hypothyroidism (RIHT) in patients receiving radiotherapy (RT) to the neck. Study Design: This is a prospective cohort observational study. Place and Duration of the Study: The study was conducted at Mansoura University Hospital, Mansoura, Egypt, between April 2016 until March 2019. Methods: We have completed 2 years of follow up to 50 patients with different malignancies who were treated by radiotherapy to the neck. Baseline assessment of the thyroid clinically and radiologically was done prior to the start of radiotherapy. Periodic testing of the cohort through the follow up period was done by clinical examination, measurement of TSH, fT4 and thyroid ultrasonography. Results: the incidence of RIHT was 26%. No statistical significance for the clinical risk factors. The dose-volumetric risk factors were studied and showed positive results. A mean dose of 5185 cGy was found a significant risk factor. Also, V40 ≥ 89%, V45 ≥ 63.5%, V50 ≥ 22.5% were found to be the cutoff predictors for the threshold radiation dose to induce hypothyroidism. Also decreasing the size of the gland by ≥0.7 cm3, fT4 value by ≥ 3.5 pmol/L and TSH by ≥ 0.75 uIU/L after one year from the end of EBRT is the cutoff value for prediction of occurrence of RIHT within the 2nd year of follow up. Conclusion: RIHT is a considerable late adverse effect for patients receiving RT to the neck. Mean dose, V40, V45 and V50 were found significantly related to RIHT. Mean dose of ≥ 5185 cGy, V40 ≥ 89%, V45 ≥ 63.5%, V50≥ 22.5% were proven to be the dose-volumetric threshold.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dose-volumetric Predictors for Thyroid Dysfunction after 3D Conformal Radiotherapy: An Observational, Prospective Study

AlJamal

El-Naby

El‐Badrawy

et al. 2020

JCTI

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Risk factors of early thyroid dysfunction after definitive radiotherapy in nasopharyngeal carcinoma patients

et al. 2023

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BackgroundTo explore the patterns and risk factors of early thyroid dysfunction in nasopharyngeal carcinoma (NPC) patients within 1 year after intensity‐modulated radiation therapy (IMRT).MethodsPatients with NPC who received definitive IMRT between April 2016 and April 2020 were included. All patients had normal thyroid function before definitive IMRT. The chi‐square test, Student's T‐test, Mann–Whitney U test, Kaplan–Meier method, receiver operating characteristics curve, and Cox proportional hazard analysis were used for statistical analysis.ResultsA total of 132 NPC patients were identified. Of these patients, 56 (42.4%) had hypothyroidism and 17 (12.9%) had hyperthyroidism. The median time to hypothyroidism and hyperthyroidism was 9 months (range, 1–12 months) and 1 month (range, 1–6 months) after definitive IMRT, respectively. In patients with hypothyroidism, 41 (73.2%) had subclinical hypothyroidism and 15 (26.8%) had clinical hypothyroidism. In those with hyperthyroidism, 12 patients (70.6%) had subclinical hyperthyroidism, and five patients (29.4%) had clinical hyperthyroidism. Age, clinical stage, thyroid volume, and V45 were independent risk factors for early radiation‐induced hypothyroidism within 1 year after IMRT. Patients aged <47 years, stage III/IV disease, or pre‐irradiation thyroid volume < 14 cm3 had higher risks of developing hypothyroidism.ConclusionPrimary subclinical hypothyroidism was the most common subtype of early thyroid dysfunction in NPC patients within 1 year after IMRT. Age, clinical stage, thyroid volume, and V45 were independent risk factors for early radiation‐induced hypothyroidism in NPC patients.

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Treatment of Head and Neck Cancers with MR-Linac

Khriguian,

Gharzai,

Heukelom

et al. 2024

A Practical Guide to MR-Linac

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Radiation-Induced Hypothyroidism After Radical Intensity Modulated Radiation Therapy for Oropharyngeal Carcinoma

Cited by 16 publications

References 37 publications

Dose-volumetric Predictors for Thyroid Dysfunction after 3D Conformal Radiotherapy: An Observational, Prospective Study

Dose-volumetric Predictors for Thyroid Dysfunction after 3D Conformal Radiotherapy: An Observational, Prospective Study

Risk factors of early thyroid dysfunction after definitive radiotherapy in nasopharyngeal carcinoma patients

Treatment of Head and Neck Cancers with MR-Linac

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