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The incidence of hypothyroidism in patients of head and neck carcinoma treated with radiotherapy and added risk of hypothyroidism with the addition of chemotherapy

Published online by Cambridge University Press:  07 September 2020

Dharmendra Singh Open the ORCID record for Dharmendra Singh [Opens in a new window] ,
Niladri Roy ,
Suparna Kanti Pal ,
Siddhartha Basu  and
Suman Meyur
Dharmendra Singh*
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, Patna, India
Niladri Roy
Affiliation:
Department of Radiotherapy, Medical College and Hospital, Kolkata, India
Suparna Kanti Pal
Affiliation:
Department of Radiotherapy, Bankura Sammilani Medical College, Bankura, West Bengal, India
Siddhartha Basu
Affiliation:
Department of Radiotherapy, Institute of Post Graduate Medical Education and Research, Kolkata, India
Suman Meyur
Affiliation:
Department of Radiotherapy, Institute of Post Graduate Medical Education and Research, Kolkata, India
*
Author for correspondence: Dharmendra Singh, Department of Radiotherapy, All India Institute of Medical Sciences, Phulwarisharif, Patna, Bihar801507, India. E-mail: babu.dsingh.singh35@gmail.com
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Abstract

Background:

Head and neck cancer (HNC) is the most common malignancy in the Indian males. Most of the cases of HNC present in locally advanced stage and requires a multidisciplinary management approach. Radical or adjuvant external beam radiotherapy (EBRT) is one of the important integral components of the management of HNC.

Aim:

To find the incidence of hypothyroidism (HT) in patients of HNC treated with radiotherapy with or without concurrent chemotherapy.

Methods:

A prospective, single institutional longitudinal observational study conducted at the department of radiotherapy, Institute of Post Graduate Medical Education and Research, Kolkata.

Results:

In this study, data of 118 patients were analysed. The median age at presentation was 56 years. The most common primary site of malignancy was oral cavity (39%). The patients were stage I, stage II and stage III as 11, 37·3 and 51·7% respectively. The median dose of EBRT was 66 Gy. HT statistically significantly correlated with primary site of malignancy (p = 0·001), dose of EBRT (p = 0·005). At the end of follow-up of 6 months, 39·8% developed HT.

Conclusion:

The thyroid gland is an important organ at risk while considering EBRT to neck region. The inclusion of thyroid function test in routine follow-up is mandated.

Keywords

Iatrogenic hypothyroidismincidence of hypothyroidismradiation induced hypothyroidism
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 1 , March 2022 , pp. 14 - 20
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Globocan India (2018) Population fact sheets. pp 1–2; https://gco.iarc.fr/today/data/factsheets/populations/356-india-fact-sheets.pdf. Accessed on 29th August 2019.Google Scholar
Singh, M, Prasad, CP, Singh, TD, Kumar, L. Cancer research in India: challenges & opportunities. Indian J Med Res 2018; 148 (4): 362–365.Google ScholarPubMed
Jemal, A, Siegel, R, Ward, E, Murray, T, Xu, J, Thun, MJ. Cancer statistics. CA Cancer J Clin 2007; 57 (1): 43–66.CrossRefGoogle ScholarPubMed
Groover, Ta, Christie, AC, Merritt, EA, Coe, Fo, McPeak, EM. Roentgen irradiation in the treatment of hyperthyroidism: a statistical evaluation based on three hundred and five cases. JAMA 1929; 92 (21): 1730–1734.CrossRefGoogle Scholar
Posner, MR, Ervin, TJ, Fabian, RL, Weichselbaum, RR, Miller, D, Norris, CM. Incidence of hypothyroidism following multimodality treatment for advanced squamous cell cancer of head and neck. Laryngoscope 1984; 94: 451–454.CrossRefGoogle Scholar
Oken M, Creech R, Tormey D et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group; https://ecog-acrin.org/resources/ecog-performance-status. Accessed 3rd January 2015.Google Scholar
Edge, SB, Compton, CC, Fritz, AG, Green, FL. AJCC Cancer Staging Manual. 7th edition. New York: Springer, 2010; 355–360.Google ScholarPubMed
Nadarajah, V, Michelle, D. Williams; epidemiologic trends in head and neck cancer and aids in diagnosis. Oral Maxillofacial Surg Clin N Am 2014; 26: 123–141.Google Scholar
Felix, H, Dupre, N, Drape, M, Court, L. Long-term influence of radiotherapy for cancer of larynx on the appearance of myxedema. Lyon Med 1961; 93: 1043–1050.Google ScholarPubMed
Markson, JL, Flatman, GE. Myxedema after deep X-ray therapy to the neck. Br Med Jr 1965; 1 (1): 1228–1230.10.1136/bmj.1.5444.1228CrossRefGoogle Scholar
Tell, R, Sjödin, H, Lundell, G, Lewin, F, Lewensohn, R. Hypothyroidism after external radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 1997; 39 (2): 303–308.CrossRefGoogle ScholarPubMed
Aich, RK, Deb, AR, Pal, S, Naha, BL Ray: a Iatrogenc hypothyroidism: a consequence of external beam radiotherapy to the head & neck malignancies. J Can Res Ther 2005; 1: 142–146.CrossRefGoogle Scholar
Srikantia, N, Rishi, KS, Janaki, M G, Bilimagga, RS, Ponni, A, Rajeev, A G, Kaushik, K, Dharmalingam, M. How common is hypothyroidism after external radiotherapy to neck in head and neck cancer patients. Indian J Med Paediatr Oncol 2011; 32: 143–148.Google ScholarPubMed
Tell, R, Sjödin, H, Lundell, G, Lewin, F, Lewensohn, R. Hypothyroidism after external radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 1997; 39 (2): 303–308.CrossRefGoogle ScholarPubMed
Bhatia, S, Ramsay, NK, Bantle, JP, Mertens, A. Robison ll. thyroid abnormalities after therapy for Hodgkin’s disease in childhood. Oncologist 1996; 1: 62–67.10.1634/theoncologist.1-1-62CrossRefGoogle ScholarPubMed
Turner, Sl, Tiver, KW, Boyages, SC. Thyroid dysfunction following radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 1995; 31: 279–283.10.1016/0360-3016(93)E0112-JCrossRefGoogle ScholarPubMed
DeGroot, LJ. Radiation and thyroid disease. Baillieres Clin Endocrinol Metab 1988;2 (3): 777–791. doi:10.1016/s0950-351x(88)80065-x CrossRefGoogle ScholarPubMed
Hancock, Sl, McDougall, IR, Constine, LS. Thyroid abnormalities after therapeutic external radiation. Int J Radiat Oncol Biol Phys 1995; 31: 1165–1170.CrossRefGoogle ScholarPubMed
Cinar, U, Yigit, O, Alkan, S et al. The effect of laryngectomy and postoperative radiotherapy on thyroid gland functions. Kulak Burun Bogaz Ihtis Derg 2003; 10: 226–230.Google ScholarPubMed
Chougule, A, Kochar, B. Thyroid dysfunction following therapeutic external radiation to head and neck cancer. Asian Pac J Cancer Prev 2011; 12 (2): 443–445.Google ScholarPubMed
Aich, RK, Deb, AR, Pal, S, Naha, BL, Ray, A. Iatrogenc hypothyroidism: a consequence of external beam radiotherapy to the head & neck malignancies. J Can Res Ther 2005; 1: 142–146.CrossRefGoogle Scholar
Nishiyama, K, Tanaka, E, Tarui, Y, Miyauchi, K, Okagawa, K. A prospective analysis of subacute thyroid dusfunction after neck irradiation. Int J Radiat Oncol Biol Phys 1996; 34: 439–444.CrossRefGoogle Scholar
Sinard, RJ, Tobin, EJ, Mazzaferri, EL, Hodgson, SE, Young, DC, Kunz, AL. Hypothyroidism after treatment for nonthyroid head and neck cancer. Arch Otolaryngol Head Neck Surg 2000; 126: 652–657.CrossRefGoogle ScholarPubMed
Cooper, DS. Subclinical hypothyroidism. N Engl J Med 2001; 345: 260–265.CrossRefGoogle ScholarPubMed
Tell, R, Sjödin, H, Lundell, G, Lewin, F, Lewensohn, R. Hypothyroidism after external radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 1997; 39 (2): 303–308.CrossRefGoogle ScholarPubMed