Ameliyatsız Primer Baş ve Boyun Malignitelerinde Radyoterapi Sonrası Tiroid Fonksiyonlarının Değerlendirilmesi

Öz

Amaç: Bu çalışmada primer baş ve boyun malignitesi nedeniyle radyoterapi uygulanan hastalarda tiroid fonksiyon bozukluğunun araştırılması amaçlandı. Gereç ve Yöntemler: Çalışma 1 Ocak 2008 ile 31 Ocak 2017 tarihleri arasında Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Hastanesi'nde baş ve boyun bölgesinin primer malignitesi nedeniyle radyoterapi alan ve ameliyat geçirmeyen hastalarla gerçekleştirildi. Veriler retrospektif olarak hastane kayıtlarından kaydedildi. Bulgular: Toplam 132 kanser hastasının sonuçları incelendi. İncelenen bireylerin %52.28 (n = 69) glottik / supraglottik larinks kanseri, %15.15 (n = 20) nazofarenks kanseri ve %6.06 (n = 8) hodgkin lenfoma hastalarından oluşuyordu. Hastaların %78.8'i (n = 104) erkekti ve ortanca yaş 60.5 idi. Medyan tedavi süresi 44 (min = 8, maks = 354) gündü. Hastaların %28.8'inde (n = 38) anormal TSH değeri saptandı. Bireylerin %15.9'unda (n = 21) hipotiroidizm, %12.9'unda (n = 17) hipertiroidizm gelişti. Radyoterapi öncesi dönemde TSH anormalliği %29.0'ında (n = 11) ve radyoterapi sonrası dönemde %71.0'ında tespit edildi. Normal TSH grubu ile radyoterapi sonrası anormal TSH'si olanlar arasında yaş ve cinsiyet açısından anlamlı fark yoktu; ancak radyoterapi öncesi anormal TSH değeri olan hastaların yaşı anlamlı olarak daha yüksekti (p <0.001). Sonuç: Radyoterapi alan baş ve boyun malignitesi olan hastaların rutin takibinde, özellikle subklinik vakaların erken saptanması için tiroid fonksiyon testlerinin incelenmesi önemli olabilir.

Anahtar Kelimeler

• Baş ve boyun maligniteleri
• radyoterapi
• tiroid disfonksiyonu

Evaluation of Thyroid Functions After Radiotherapy in Primary Head and Neck Malignancies without Surgery

Öz

Aim: In this study, it was aimed to investigate thyroid dysfunction in patients who underwent radiotherapy due to primary head and neck malignancy. Material and Methods: The study was carried out between January 1, 2008 and January 31, 2017 at Zonguldak Bulent Ecevit University Health Practice and Research Hospital with patients who received radiotherapy due to primary malignancy of the head and neck region and did not undergo surgery. The data were recorded retrospectively from hospital records. All analyses were performed on SPSS v21 (SPSS Inc., Chicago, IL, USA). Two-tailed p-values of less than 0.05 were considered statistically significant. Results: The results of a total of 132 cancer patients were examined. Cancers examined mostly consisted of 52.28% (n = 69) glottic / supraglottic larynx cancer, 15.15% (n = 20) nasopharynx cancer, and 6.06% (n = 8) hodgkin lymphoma patients. In addition to ;78.8% (n = 104) of the patients were male and the median age was 60.5 (min = 15, max = 84) years. Median duration of treatment was 44 (min = 8, max = 354) days. It was determined that 28.8% (n = 38) of the patients had abnormal TSH value. Hypothyroidism developed in 15.9% (n = 21) of the individuals and hyperthyroidism developed in 12.9% (n = 17). And 29.0% (n = 11) of the TSH abnormalities determined in the preradiotherapy period and 71.0% in the post-radiotherapy period. There was no significant difference in age and gender between the normal TSH group and those that had abnormal TSH after radiotherapy; however, the age of patients with abnormal TSH value before radiotherapy was significantly higher (p <0.001). Conclusion: Thyroid dysfunction in head and neck malignancies may also be seen before treatment, but the frequency of thyroid dysfunction increases after radiotherapy. The effect of radiotherapy on the thyroid gland is not affected by variables such as age and gender. Patients who develop thyroid dysfunction after radiotherapy were younger than patients with thyroid dysfunction before radiotherapy. In the routine follow-up of patients with head and neck malignancy who receive radiotherapy, the examination of thyroid function tests could be important for the early detection of particularly subclinical cases.

Anahtar Kelimeler

• Head and neck malignancies
• Radiotherapy
• Thyroid dysfunction

Kaynakça

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