Correlative study of dose to thyroid and incidence of subsequent dysfunction after head and neck radiation

Head Neck. 2017 Mar;39(3):548-554. doi: 10.1002/hed.24643. Epub 2016 Dec 1.

Abstract

Background: Thyroid dysfunction is common after radiotherapy (RT) for patients with head and neck cancers. We attempted to discover RT dose parameters that correspond with RT-induced thyroid dysfunction.

Methods: Records of 102 patients who received RT from 2008 to 2010 were reviewed with respect to thyroid function. Abnormalities were grouped in 2 ways: (1) none, transient, or permanent; and (2) overt or subclinical.

Results: At median follow-up of 33.5 months, incidence of any thyroid abnormality was 39.2% (women vs men - 50% vs 35%). Permanent dysfunction was seen in 24.5% with higher incidence in women versus men (42.9% vs 17.6%; p = .0081). Permanent abnormalities most strongly correlated with D50% (p = .0275). V50Gy also correlated with thyroid dysfunction post-RT (p = .0316). Concurrent chemotherapy increased permanent dysfunction (p = .0008).

Conclusion: Achieving D50% <50 Gy, V50 <50%, and mean dose <54.58 Gy during RT planning may decrease the incidence; whereas female sex and concurrent chemotherapy seem to increase the risk of RT-induced hypothyroidism. © 2016 Wiley Periodicals, Inc. Head Neck 39: 548-554, 2017.

Keywords: head and neck radiotherapy; hypothyroidism; radiation dose volume histogram (DVH); radiation toxicity; thyroid abnormality.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Chi-Square Distribution
  • Cohort Studies
  • Dose-Response Relationship, Radiation
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Hypothyroidism / epidemiology
  • Hypothyroidism / etiology*
  • Hypothyroidism / physiopathology
  • Male
  • Middle Aged
  • Prognosis
  • Radiation Injuries / epidemiology
  • Radiation Injuries / etiology
  • Radiation Injuries / physiopathology*
  • Radiotherapy / adverse effects*
  • Radiotherapy / methods
  • Radiotherapy Dosage
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Thyroid Diseases / epidemiology
  • Thyroid Diseases / etiology
  • Thyroid Diseases / physiopathology
  • Thyroid Function Tests
  • Thyroid Gland / physiopathology
  • Thyroid Gland / radiation effects
  • Treatment Outcome