A dosimetric study on radiation-induced hypothyroidism following intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma
A dosimetric study on radiation-induced hypothyroidism following intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma
复制标题
DOI：
10.3892/ol.2018.9332
复制
发表时间：
2018-11-01
期刊：
影响因子：
2.9
通讯作者：
Zhang, Longzhen
中科院分区：
文献类型：
--
作者：
Xu, Yumei;Shao, Zhiying;Zhang, Longzhen
本研究的目的是探讨甲状腺剂量学参数与鼻咽癌（NPC）患者调强放疗引起的甲状腺功能减退之间的关系。回顾性分析2008年5月至2016年12月在徐州医科大学附属医院放射肿瘤科接受治疗的52例鼻咽癌患者，根据甲状腺功能分为甲状腺功能正常组和甲状腺功能低下组。分析甲减与临床或剂量学参数的关系。与男性相比，女性患放射性甲状腺功能减退症（RIHT）的概率显著增加（P=0.010）。RIHT的发生与放疗前甲状腺体积呈显著负相关（P=0.048）。甲减组的平均剂量（Dmean）和V50较甲减组显著增加（P=0.017和P=0.023）。在治疗优化期间，与未限制组相比，与甲状腺相关的剂量限制对甲状腺功能具有显著保护作用（P=0.034）。根据受试者工作特性曲线，Dmean的阈值为5，160 cGy，V50的阈值为54.5%。Dmean> 5，160 cGy时，3年累积RIHT发生率为67.8%，Dmean为54.5%时为44.6%，V50为29.9
The objective of the present study was to investigate the association between thyroid gland-dosimetric parameters and hypothyroidism induced by intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma (NPC). A total of 52 patients with NPC treated in the Department of Radiation Oncology of The Affiliated Hospital of Xuzhou Medical University, from May 2008 to December 2016 were retrospectively enrolled in the present study and divided into two groups based on thyroid function: The euthyroid and hypothyroid groups. The association between hypothyroidism and clinical or dosimetric parameters were analyzed. Females had a significantly increased probability of suffering from radiation-induced hypothyroidism (RIHT), compared with males (P=0.010). The occurrence of RIHT was significantly negatively associated with thyroid volume prior to radiotherapy (P=0.048). Furthermore, the mean dose (Dmean) and V50 in the hypothyroidism group were significantly increased, compared with the euthyroidism group (P=0.017 and P=0.023, respectively). During the treatment optimization period, dose constraints associated with the thyroid gland demonstrated a significantly protective effect on thyroid function compared with the unconstrained group (P=0.034). According to the receiver operating characteristic curves, the threshold value was 5,160 cGy for Dmean and 54.5% for V50. The 3-year cumulative incidence of RIHT was 67.8% when the Dmean value was >5,160 cGy and 44.6% when the Dmean was 54.5%, and 29.9% when the V50 was