HYPOTHYROIDISM IN HEAD-AND-NECK CARCINOMA PATIENTS AFTER RADIATION

Authors

  • Subhash Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.
  • Gaurav Gupta Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.
  • Rajkumar Verma Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.
  • Mukul Yadav Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i11.48650

Keywords:

Hypothyroidism, Head-and-neck carcinoma, Radiation

Abstract

Objective: The objective of the study was to determine the incidence of clinical hypothyroidism in patients undergoing radiation therapy for head-and-neck carcinomas.

Methods: One hundred and fifty patients with head-and-neck cancers visiting the Department of Otorhinolaryngology and head-and-neck surgery and undergoing treatment after histological confirmation at the Department of ENT and Radiation Oncology at Sardar Patel Medical College, Bikaner, Rajasthan, from January 2022 to January 2023 were taken up for the study. Tumor response and symptom relief were monitored at the completion of treatment, at 3 months, and at 6 months.

Results: Mean age of 51.42±12.24 years (21–78 years), 59.33% were males, and 63.34% of the study population was residing in rural areas. About 30.67% were in the oral cavity followed by 28.67% and 28.5 in the larynx and nasopharynx, respectively. Mean FT4 was 1.35±0.40 before radiotherapy and decreased to 1.20±0.43 after 3 months and 1.12±0.40 after 6 months of radiotherapy (p<0.0001*). Mean thyroid stimulating hormone was 2.14±2.50 before radiotherapy and increased to 3.55±4.5 after 3 months and 4.1±6.8 after 6 months of radiotherapy (p<0.0001*). At 3-month follow-up, 8% had clinical hypothyroid, at 6-month follow-up, 18% had clinical thyroid (p<0.05).

Conclusion: Thyroid hormone monitoring following radiotherapy for head-and-neck cancers should incorporate part of follow-up of these patients, especially those patients who receive chemotherapy with radiotherapy.

Downloads

Download data is not yet available.

Author Biographies

Subhash, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.

Resident, Department of ENT

Gaurav Gupta, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.

Professor & HOD, Department of ENT

Rajkumar Verma, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.

Resident, Department of ENT

Mukul Yadav, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India.

Resident, Department of ENT

References

World. Globocan 2020: New Global Cancer Data. Geneva: Union Internationale Contra le Cancer; 2020. Available from: https://www. uicc.org/news/globocan-2020-new-global-cancer-data [Last accessed on 2023 Feb].

GLOBOCAN I. Iarc; 2020. Available from: https://www.356-india-fact-sheets.pdf.fr

Bhide SA, Nutting CM. Advances in radiotherapy for head and neck cancer. Oral Oncol 2010;46:439-41. doi: 10.1016/j. oraloncology.2010.03.005, PMID 20409746

Blanchard P, Bourhis J, Lacas B, Posner MR, Vermorken JB, Cruz Hernandez JJ, et al. Taxane-cisplatin-fluorouracil as induction chemotherapy in locally advanced head and neck cancers: An individual patient data meta-analysis of the meta-analysis of chemotherapy in head and neck cancer group. J Clin Oncol 2013;31:2854-60. doi: 10.1200/ JCO.2012.47.7802, PMID 23835714

Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS, Preston-Martin S, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988;48:3282-7. PMID 3365707

IMRT Documentation Working Group, Holmes T, Das R, Low D, Yin FF, Balter J, et al. American society of radiation oncology recommendations for documenting intensity-modulated radiation therapy treatments. Int J Radiat Oncol Biol Phys 2009;74:1311-8. doi: 10.1016/j.ijrobp.2009.04.037, PMID 19616738

Choudhury A, Budgell G, MacKay R, Falk S, Faivre-Finn C, Dubec M, et al. The future of image-guided radiotherapy. Clin Oncol (R Coll Radiol) 2017;29:662-6. doi: 10.1016/j.clon.2017.04.036, PMID 28511968

Kumari S, Gondi J, Nemade H, Chandra Sekhara Rao LM, Gudipudi D, Rao TS. Hypothyroidism in carcinoma of the tongue with adjuvant treatment. Rambam Maimonides Med J 2017;8. doi: 10.5041/ RMMJ.10290, PMID 28448252

Bernát L, Hrušák D. Hypothyroidism after radiotherapy of head and neck cancer. J Craniomaxillofac Surg 2014;42:356-61. doi: 10.1016/j. jcms.2013.09.009, PMID 24210455

Laway BA, Shafi KM, Majid S, Lone MM, Afroz F, Khan S, et al. Incidence of primary hypothyroidism in patients exposed to therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland. Indian J Endocrinol Metab 2012;16:S329-31. doi: 10.4103/2230-8210.104078, PMID 23565416

Yoden E, Soejima T, Maruta T, Demizu Y, Nishimura H, Ejima Y, et al. Hypothyroidism after radiotherapy to the neck. Int J Radiat Oncol Biol Phys 2001;51:337-8.

Fujiwara M, Kamikonya N, Odawara S, Suzuki H, Niwa Y, Takada Y, et al. The threshold of hypothyroidism after radiation therapy for head and neck cancer: A retrospective analysis of 116 cases. J Radiat Res 2015;56:577-82. doi: 10.1093/jrr/rrv006, PMID 25818629

Koc M, Capoglu I. Thyroid dysfunction in patients treated with radiotherapy for neck. Am J Clin Oncol 2009;32:150-3. doi: 10.1097/ COC.0b013e3181845517, PMID 19307948

Immanuel V, Sachdeva J, Singh N, Kingsley PA, Chandran RS. Evaluation of thyroid dysfunction in patients with head and neck cancer receiving radiation therapy or chemoradiation. Parameters 2019;10:V50.

Langerman A, Athavale SM, Rangarajan SV, Sinard RJ, Netterville JL. Natural history of cervical paragangliomas: Outcomes of observation of 43 patients. Arch Otolaryngol Head Neck Surg 2012;138:341-5. doi: 10.1001/archoto.2012.37, PMID 22431860

Sinard RJ, Tobin EJ, Mazzaferri EL, Hodgson SE, Young DC, Kunz AL, et al. Hypothyroidism after treatment for nonthyroid head and neck cancer. Arch Otolaryngol Head Neck Surg 2000;126:652-7. doi: 10.1001/archotol.126.5.652, PMID 10807335

Alterio D, Jereczek-Fossa BA, Franchi B, D’Onofrio A, Piazzi V, Rondi E, et al. Thyroid disorders in patients treated with radiotherapy for head-and-neck cancer: A retrospective analysis of seventy-three patients. Int J Radiat Oncol Biol Phys 2007;67:144-50. doi: 10.1016/j. ijrobp.2006.08.051, PMID 17084554

Published

07-11-2023

How to Cite

Subhash, G. Gupta, R. Verma, and M. Yadav. “HYPOTHYROIDISM IN HEAD-AND-NECK CARCINOMA PATIENTS AFTER RADIATION”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 11, Nov. 2023, pp. 52-55, doi:10.22159/ajpcr.2023.v16i11.48650.

Issue

Section

Original Article(s)

Most read articles by the same author(s)

<< < 1 2