Post-radiotherapy hypothyroidism in head and neck cancers: When should we be concerned?

Yıl 2017, Cilt: 27 Sayı: 6, 269 - 275, 20.12.2017

Mehmet Çelik Rasim Meral Deniz Kanlıada Levent Aydemir Bora Başaran Erkan Kıyak

Öz

Objectives: This study aims to analyze the incidence of hypothyroidism HT in patients who underwent radiotherapy RT for head and neck cancers HNC , and to determine risk factors. Patients and Methods: This study was a retrospective analysis of patients who were treated with RT alone or in combination with surgery and/or chemotherapy between January 2005 and May 2012. Patients were grouped according to the primary tumor site, TNM staging system, age, gender, total radiation dose TRD , mean radiation dose of thyroid gland MRT , neck dissection, and chemotherapy. Results: A total of 90 patients who were treated with RT were analyzed. The median age was 52±13 range, 12-87 years. The histopathologic finding of 88 patients was squamous cell carcinoma, others were adenocystic carcinoma and undifferentiated carcinoma. The median follow-up of all patients after RT was 15 range, 6-72 months. Post-radiotherapy HT was found in 31 patients 34.4% . In this group, clinical and subclinical HT was present in eight 26% and 23 74% patients, respectively. Age younger than 60 years and increased MRT especially mean thyroid dose 20 Gy< were significant risk factors for post-radiotherapy HT p<0.05 . Conclusion: Physicians should pay more attention to HT in patients who were treated with RT for HNC during follow-up.

Anahtar Kelimeler

Head and neck cancers, hypothyroidism, mean radiation dose of thyroid gland, radiotherapy thyroid gland

Baş-boyun kanserlerinde radyoterapi sonrası hipotiroidi: Ne zaman endişelenmeliyiz?

Öz

Amaç: Bu çalışmada, baş-boyun kanserlerinde HNC radyoterapi RT uygulanan hastalarda hipotiroidi HT insidansının analiz edilmesi ve risk faktörlerinin belirlenmesi amaçlandı.Hastalar ve Yöntemler: Bu çalışma, Ocak 2005 - Mayıs 2012 tarihleri arasında tek başına RT ile tedavi edilen veya cerrahi veya kemoterapi ile kombine edilen hastaların retrospektif bir analizidir. Hastalar primer tümör, TNM evreleme sistemi, yaş, cinsiyet, total radyasyon dozu TRD , tiroid bezinin ortalama radyasyon dozu MRT , boyun diseksiyonu uygulaması ve kemoterapiye göre gruplandırıldı.Bulgular: Radyoterapi ile tedavi edilen toplam 90 hasta analiz edildi. Medyan yaş 52±13 yıl idi. Seksen sekiz hastanın histopatolojik bulgusu skuamöz hücreli karsinom, diğerleri adenokistik karsinom ve indifferansiye karsinom idi. Radyoterapi sonrası tüm hastaların medyan takip süresi 15 ay idi. Post-radyoterapi HT, 31 hastada %34.4 bulundu. Bu grupta sırasıyla sekiz %26 ve 23 %74 hastada klinik ve subklinik HT vardı. Altmış yaşın altındaki yaş ve MRT artışı özellikle ortalama tiroid dozu 20 Gy< , radyoterapi sonrası HT için anlamlı risk faktörleri idi p

Anahtar Kelimeler

Baş ve boyun kanserleri, hipotiroidizm, tiroid bezinin ortalama radyasyon dozu, radyoterapi, tiroid bezi

Kaynakça

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