Thyroid disorders in patients treated with radiotherapy for head-and-neck cancer: A retrospective analysis of seventy-three patients
Thyroid disorders in patients treated with radiotherapy for head-and-neck cancer: A retrospective analysis of seventy-three patients
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DOI：
10.1016/j.ijrobp.2006.08.051
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发表时间：
2007-01-01
影响因子：
7
通讯作者：
Orecchia, Roberto
中科院分区：
文献类型：
--
作者：
Alterio, Daniela;Jereczek-Fossa, Barbara Alicja;Orecchia, Roberto
目的：探讨头颈部肿瘤放疗患者甲状腺功能紊乱的发生率及剂量分布。方法与材料：回顾性分析我科73例头颈癌患者的治疗资料。甲状腺功能主要通过促甲状腺激素（TSH）的测定来评价。对57例患者的治疗方案进行回顾性分析。以甲状腺体积吸收10、30、50 Gy的百分比（分别为V10、V30、V50）进行统计分析。结果：大多数患者（61%）甲状腺功能正常，19例（26%）甲状腺功能减退。甲状腺平均体积为30.39 cc，位于峡部的3号点吸收剂量较其他点低（p < 0.0001）。V10、V30、V50的中位数分别为92%（范围57 ~ 100%）、75%（范围28.5 ~ 100%）、35%（范围3 ~ 83%）。性别与毒性（任何类型甲状腺疾病的存在）相关（p < 0.05），与男性相比，女性的TSHr水平较高（相对TSH =患者值/实验室范围最大值）（p = 0.0005），甲状腺体积较小（p = 0.0012）。TSHr值与甲状腺体积有关，前野中线屏蔽块的存在与相对游离甲状腺素（FT4r =患者值/实验室范围最大值）值有关。结论：性别和甲状腺体积似乎在甲状腺毒性的发生中起重要作用，但需要进一步研究放疗引起的甲状腺毒性的剂量效应关系。(c) 2007爱思唯尔公司
Purpose: To evaluate the incidence of thyroid disorders and dose distribution to the thyroid in patients treated with radiotherapy for head-and-neck carcinomas.Methods and Materials: A retrospective evaluation of data from 73 patients treated for head-and-neck cancers in our department was performed. Thyroid function was evaluated mainly by the measurement of thyrotropin (thyroid stimulating hormone [TSH]). A retrospective analysis of treatment plans was performed for 57 patients. Percentages of thyroid glandular volume absorbing 10, 30, and 50 Gy (V10, V30, and V50 respectively) were considered for statistical analysis.Results: A majority of patients (61 %) had a normal thyroid function whereas 19 patients (26%) had hypothyroidism. Mean thyroid volume was 30.39 cc. Point 3 (located at isthmus) absorbed lower doses compared with other points (p < 0.0001). Median values of V10, V30, and V50 were 92% (range, 57-100%),75% (range, 28.5-100%), and 35% (range, 3-83 %) respectively. Gender was associated with toxicity (presence of any kind of thyroid disorders) (p < 0.05), with females displaying higher levels of TSHr (relative TSH = patient's value/maximum value of the laboratory range) (p = 0.0005) and smaller thyroid volume (p = 0.0012) compared with male population. TSHr values were associated with thyroid volume, and the presence of midline shielding block in the anterior field was associated with relative free thyroxine (FT4r = patient's value/maximum value of the laboratory range) values.Conclusions: Gender and thyroid volume seem to play an important role in the occurrence of thyroid toxicity, but further studies on dose-effect relationship for radiotherapy-induced thyroid toxicity are needed. (c) 2007 Elsevier Inc.