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Hypothyroidism in patients treated with radiotherapy for head and neck carcinoma: standardised long-term follow-up study

Published online by Cambridge University Press:  15 March 2016

J R Alba*
Affiliation:
Department of ENT, University General Hospital, Valencia Medical School, Spain
J Basterra
Affiliation:
Department of ENT, University General Hospital, Valencia Medical School, Spain
J C Ferrer
Affiliation:
Department of Endocrinology, University General Hospital, Valencia Medical School, Spain
F Santonja
Affiliation:
Department of Statistics and Operations Research, University of Valencia, Spain
E Zapater
Affiliation:
Department of ENT, University General Hospital, Valencia Medical School, Spain
*
Address for correspondence: Dr Jose Ramon Alba, Plaza del Reino n°1, Piso 1, Pta 3, Alzira, Valencia 46600, Spain E-mail: joseramon43@hotmail.com

Abstract

Objective:

Hypothyroidism is a common complication when radiotherapy is part of the treatment for head and neck tumours. This study aimed to show the incidence of hypothyroidism and possible risk factors in these patients.

Methods:

Factors related to the population, tumour, treatment and occurrence of hypothyroidism were analysed in 241 patients diagnosed with head and neck carcinoma.

Results:

Approximately 53 per cent of patients were diagnosed with radiation-induced hypothyroidism. Its occurrence was related to: tumour location, laryngeal surgery type, neck dissection type, post-operative complications, cervical radiotherapy and radiotherapy unit type (linear particle accelerator or telecobalt therapy technology).

Conclusion:

Control of thyroid function should be standardised for several years after treatment, particularly in patients with risk factors, such as those treated with telecobalt therapy, those with post-operative complications and for whom the thyroid parenchyma is included in the irradiated area (laryngeal or pharyngeal location and bilateral cervical radiation).

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Smith, GL, Smith, BD, Giordano, SH, Shih, YC, Woodward, WA, Strom, EA et al. Risk of hypothyroidism in older breast cancer patients treated with radiation. Cancer 2008;112:1371–9CrossRefGoogle ScholarPubMed
2 Aich, RK, Ranjan, DA, Pal, S, Naha, BL, Amitabh, R. Iatrogenic hypothyroidism: a consequence of external beam radiotherapy to the head & neck malignancies. J Cancer Res Ther 2005;1:142–6Google Scholar
3 Sinard, RJ, Tobin, EJ, Mazzaferri, EL, Hodgson, SE, Young, DC, Kunz, AL et al. Hypothyroidism after treatment for nonthyroid head and neck cancer. Arch Otolaryngol Head Neck Surg 2000;126:652–7Google Scholar
4 Alterio, D, Jereczek-Fossa, BA, Franchi, B, D'Onofrio, A, Piazzi, V, Rondi, E et al. Thyroid disorders in patients treated with radiotherapy for head-and-neck cancer: a retrospective analysis of seventy-three patients. Int J Radiat Oncol Biol Phys 2007;67:144–50CrossRefGoogle ScholarPubMed
5 Lo Galbo, AM, de Bree, R, Lips, P, Leemans, CR. Detecting hypothyroidism after treatment for laryngeal or hypopharyngeal carcinomas: a nationwide survey in The Netherlands. Eur Arch Otorhinolaryngol 2009;266:713–18CrossRefGoogle ScholarPubMed
6 Karmisholt, J, Andersen, S, Lauber, P. Variation in thyroid function in subclinical hypothyroidism: importance of clinical follow-up and therapy. Eur J Endocrinol 2011;164:317–23Google Scholar
7 Lucas Martin, AM. Subclinical hypothyroidism: to treat or not to treat? [In Spanish]. Med Clin (Barc) 2004;122:182–3Google Scholar
8 Jereczek-Fossa, BA, Alterio, D, Jassem, J, Gibelli, B, Tradati, N, Orecchia, R. Radiotherapy-induced thyroid disorders. Cancer Treat Rev 2004;30:369–84CrossRefGoogle ScholarPubMed
9 Ho, AC, Ho, WK, Lam, PK, Yuen, AP, Wei, WI. Thyroid dysfunction in laryngectomees – 10 years after treatment. Head Neck 2008;30:336–40Google Scholar
10 Tell, R, Lundell, G, Nilsson, B, Sjödin, H, Lewin, F, Lewensohn, R. Long-term incidence of hypothyroidism after radiotherapy in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys 2004;60:395400 Google Scholar
11 Alkan, S, Baylancicek, S, Ciftçic, M, Sozen, E, Dadaş, B. Thyroid dysfunction after combined therapy for laryngeal cancer: a prospective study. Otolaryngol Head Neck Surg 2008;139:787–91CrossRefGoogle ScholarPubMed
12 Liening, DA, Duncan, NO, Blakeslee, DB, Smith, DB. Hypothyroidism following radiotherapy for head and neck cancer. Otolaryngol Head Neck Surg 1990;103:1013 Google Scholar
13 Kumpulainen, EJ, Hirvikoski, P, Virtaniemi, A, Johasson, T, Simonen, P, Treävä, M et al. Hypothyroidism after radiotherapy for laryngeal cancer. Radiother Oncol 2000;57:97101 Google Scholar
14 de Bree, R, Lips, P, Leemans, CR. The need for patients’ endocrine function vigilance following treatment of head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2008;16:154–7CrossRefGoogle ScholarPubMed
15 Ozawa, H, Saitou, H, Mizutari, K, Takata, Y, Ogawa, K. Hypothyroidism after radiotherapy for patients with head and neck cancer. Am J Otolaryngol 2007;28:46–9CrossRefGoogle ScholarPubMed
16 Gal, RL, Gal, TJ, Klotch, DW, Cantor, AB. Risk factors associated with hypothyroidism after laryngectomy. Otolaryngol Head Neck Surg 2000;123:211–17Google Scholar
17 Bhandare, N, Kennedy, L, Malyapa, RS, Morris, CG, Mendenhall, WM. Primary and central hypothyroidism after radiotherapy for head-and-neck tumors. Int J Radiat Oncol Biol Phys 2007;68:1131–9Google Scholar
18 Smolarz, K, Malke, G, Voth, E, Scheidhauer, K, Eckel, H, Jungehülsing, M et al. Hypothyroidism after therapy for larynx and pharynx carcinoma. Thyroid 2000;10:425–9CrossRefGoogle ScholarPubMed
19 Bohannon, IA, Carrol, WR, Magnuson, JS, Rosenthal, EL. Closure of post-laryngectomy pharyngocutaneous fistulae. Head Neck Oncol 2011;3:29 Google Scholar