A CROSS-SECTIONAL STUDY OF THE ACUTE EFFECTS OF HEAD AND NECK RADIOTHERAPY ON THE THYROID VOLUME AND FUNCTION

Yıl 2020, Cilt: 22 Sayı: 1, 50 - 57, 30.04.2020

Fevziye İlknur Kayalı Uğur Toprak Rahşan Habiboğlu

https://doi.org/10.24938/kutfd.631176

Öz

Objective: To evaluate the acute effects of radiotherapy on the volume and function of the thyroid gland.

Material and Methods: Thirty-one patients with head and neck cancer were included in the study. Patients with thyroid cancer or thyroidectomy were excluded. There was no patient for whom radiotherapy was the only tretment modality. Thyroid function tests, thyroglobulin and thyroid volume imaging were evaluated before and immediately after radiotherapy, 

Results: After radiotherapy 13 patients had dysfunction. Among 13, 8 had subclinical hyperthyroidism, 1 had clinical hyperthyroidism, 1 had subclinical hypothyroidism and 3 developed clinical hypothyroidism. After chemoradiotherapy all patients had significantly decreased FT3 (p<0.001). FT4 slightly increased in all of the patients other than operated patients (p>0.05). After treatment, the TSH decreased in patients who were not operated but given chemotherapy whereas it was increased in patients who were operated but not given chemotherapy (p>0.05). The thyroid volume was unchanged in 2 patients, decreased in 17 patients and increased in 12 patients (p>0.05). There was no correlation between chemotherapy or surgery, and the volume of the thyroid gland. No thyroiditis was seen in the acute phase.

Conclusion: Hyperthyroidism appeared immediately after radiotherapy. The volume of the gland starts to be slightly affected in the acute phase. Due to possible clinical thyroid dysfunction, after completion of the radiotherapy patients should not be discharged without thyroid function tests.

Anahtar Kelimeler

Head and neck cancer, radiotherapy, Thyroid disfunction

Baş ve Boyun Radyoterapisinin Tiroid Volümü ve Fonksiyonu Üzerine Akut Etkileri Üzerine Kesitsel Bir Çalışma

Öz

Amaç: Radyoterapinin tiroid bezinin volümü ve işlevi üzerindeki akut etkilerini değerlendirmek.

Gereç ve Yöntemler: Çalışmaya baş boyun kanserli 31 hasta alındı. Tiroid kanseri veya tiroidektomili hastalar çalışma dışı bırakıldı. Radyoterapinin tek tedavi modalitesi olarak uygulandığı hiçbir hasta yoktu. Radyoterapiden hemen önce ve sonra tiroid fonksiyon testleri, tiroglobulin ve tiroid volüm görüntüleme yapıldı.

Bulgular: Radyoterapi sonrası 13 hastada disfonksiyon mevcuttu. On üç hastanın 8’inde subklinik hipertiroidi, 1’inde klinik hipertiroidi, 1’inde subklinik hipotiroidi ve 3’ünde klinik hipotiroidi vardı. Kemoradyoterapi sonrası tüm hastalarda anlamlı olarak azalmış FT3 mevcuttu (p<0.001). FT4, opere edilen hastalar dışındaki tüm hastalarda hafifçe artmış olarak saptandı (p>0.05). Tedavi sonrası, TSH, kemoterapi verilen ve opere edilmemiş hastalarda azalmışken, opere edilen ve kemoterapi verilmeyen hastalarda artmış olarak saptandı (p>0.05). İki hastada tiroid hacmi değişmedi, 17 hastada azaldı ve 12 hastada arttı (p>0.05). Kemoterapi veya cerrahi işlem ile tiroid bezinin hacmi arasında korelasyon yoktu. Akut fazda tiroidit görülmedi.

Sonuç: Hipertiroidinin radyoterapiden hemen sonra ortaya çıktığı sonucu gözlendi. Akut fazda bez hacmi hafifçe etkilenmeye başlar. Muhtemel klinik tiroid fonksiyon bozukluğu nedeniyle, radyoterapi tamamlandıktan sonra hastalar tiroid fonksiyon testleri yapılmadan taburcu edilmemelidir.

Anahtar Kelimeler

baş-boyun kanseri, radyoterapi, tiroid disfonksiyonu

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