Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

Reinertsen, Kristin V.; Cvancarova, Milada; Wist, Erik; Bjøro, Trine; Dahl, Alv A.; Danielsen, Turi; Fosså, Sophie D.

doi:10.1016/j.ijrobp.2008.11.037

Cited by 56 publications

(70 citation statements)

References 23 publications

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“…Radiation induced HT in patients with breast cancer has been investigated in only a few studies. [12][13][14] According to these studies, the incidence of HT varies 6% and 21% similar to our study. Bruning et al concluded that HT was significantly more frequent in patients with breast cancer who had received RT to supraclavicular field to non-irradiated breast cancer patients.…”

Section: Discussionsupporting

confidence: 90%

Thyroid Dysfunction Following Supraclavicular Irradiation in The Management of Carcinoma of the Breast.

Akyürek¹

2014

UHOD

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Radiation induced thyroid dysfunction is usually underestimated in patients with breast cancer who had supraclavicular irradiation (RT). In the present study, a total of 28 patients with breast cancer received supraclavicular RT were evaluated focusing on radiation dose-volume factors in relation to thyroid function. Thyroid function tests, including serum thyroid stimulating hormone, free thyroxine, free triiodothyronine, were analyzed prior to RT and 3,6,9,12,18 and 24 months after RT. Based on each patient's dose volume histogram (DVH), total volume of the thyroid, mean radiation dose the thyroid and percentages of thyroid volume which received radiation doses 10-50 Gy (V10-V50) were considered for statistical analysis. The median follow-up time was 25 months (range, 12.3-36 months). Of 28 patients 6 (21%) were diagnosed with hypothyroidism (HT). The median time to the development of HT was 9 months (range: 3-18 months). Mean thyroid dose was 31 Gy (19-48 Gy) and mean thyroid volume was 32 cc (12-64 cc). We found that V20 (OR= 10, 95% CI= 1.15-86.88, p= 0.05), V30 (OR= 10, 95% CI= 1.15-86.88, p= 0.05) and V40 (OR= 21, 95% CI= 1.61-273.34, p= 0.02) and mean thyroid dose ≥36 Gy (OR= 10, 95% CI= 1.15-86.88) (p= 0.05), had a significant impact on development of HT. Moreover, significant elevation was observed in mean TSH level between baseline (1.85±1.47 mIU/L) and at 6 months (3.80±7.42 mIU/L), (p= 0.003). Supraclavicular RT in patients with breast cancer appear to amplify the risk of HT. We believe further investigations in larger cohort are required to confirm our results. Keywords: Thyroid dysfunction, Breast Cancer, Radiotherapy ÖZET Meme Kanserinde Supraklavikuler Işınlama Sonrası Tiroid Fonksiyon BozukluğuSupraklavikuler radyoterapi (RT) alan meme kanserli hastalarada tiroid fonksiyon bozuklukları genellikle göz ardı edilir. Bu çalışmada supraklavikuler RT alan 28 meme kanserli hasta, radyasyon doz-volüm faktörleri ve tiroid fonksiyon testlerine fokuslanarak değerlendirildi. Tiroid stümülan hormon, serbest triiyodotironin, serbest tiroksin, RT'den önce ve 3, 6, 9,12,18 ve 24 sonra analiz edildi. Tüm hastaların doz-volüm histogramlarına (DVH) dayanarak total tiroid volümü, mean tiroid dozu ve 10-50 Gy radyasyon alan tiroid volüm yüzdesi (V10-50) istatiksel analiz için elde edildi. Ortalama takip süresi 25 aydı (12.3-36 ay). Yirmisekiz hastanın 6 (%21)'sında hipotiroidizm (HT) saptandı. Median HT gelişme zamanı 9 (3-18 ay) aydı. Mean tiroid dozu 31 Gy (19-48 Gy) ve mean tiroid volümü 32 cc (12-64 cc) idi. V20 (OR= 10, 95% CI= 1.15-86.88, p= 0.05), V30 (OR= 10, 95% CI= 1.15-86.88, p= 0.05) ve V40 (OR= 21, 95% CI= 1.61-273.34, p= 0.02) ile mean tiroid dozunun ≥36 Gy (OR= 10, 95% CI= 1.15-86.88) (p= 0.05) olması HT gelişiminde anlamlı bulundu. Ek olarak, bazal mean TSH (1.85±1.47 mIU/L) düzeyi ile karşılaştırıldığında 6. ayda (3.80±7.42 mIU/L), (p= 0.003) anlamlı fark gözlendi. Meme kanserli hastalarda supraklaviküler RT, HT riskini artırıyor görünmektedir. Sonuçlarımızın daha fazla hasta sayılı çalışma...

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Section: Discussionsupporting

confidence: 90%

Thyroid Dysfunction Following Supraclavicular Irradiation in The Management of Carcinoma of the Breast.

Akyürek¹

2014

UHOD

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“…Alterations in thyroid function have been noted in women with breast cancer with a baseline rate of autoimmune thyroid disease 2-3 times that of the general population [27]. Thyroid function may be affected by chemotherapy and radiation treatment, particularly when treatment is localized to the vicinity of the thyroid [28].…”

Section: Discussionmentioning

confidence: 99%

Reproductive health and endocrine disruption in women with breast cancer: a pilot study

Patel

Radeke

et al. 2014

Support Care Cancer

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“…The upper age limit at enrolment was 75 years. Additional eligibility criteria are explained elsewhere [8]. Patients with relapse of BC or development of other cancers were excluded during the progression of the study.…”

Section: Study Groupmentioning

confidence: 99%

Coronary calcium score in 12-year breast cancer survivors after adjuvant radiotherapy with low to moderate heart exposure – Relationship to cardiac radiation dose and cardiovascular risk factors

Tjessem

Bosse

Fosså

et al. 2015

Radiotherapy and Oncology

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Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

Cited by 56 publications

References 23 publications

Thyroid Dysfunction Following Supraclavicular Irradiation in The Management of Carcinoma of the Breast.

Thyroid Dysfunction Following Supraclavicular Irradiation in The Management of Carcinoma of the Breast.

Reproductive health and endocrine disruption in women with breast cancer: a pilot study

Coronary calcium score in 12-year breast cancer survivors after adjuvant radiotherapy with low to moderate heart exposure – Relationship to cardiac radiation dose and cardiovascular risk factors

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