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- Title
Risk factors of early thyroid dysfunction after definitive radiotherapy in nasopharyngeal carcinoma patients.
- Authors
Lian, Chen‐Lu; Zhuo, Ren‐Gong; Zhou, Rui; Yu, Yi‐Feng; Zhou, Ping; Lin, Qin; Wu, San‐Gang
- Abstract
Background: To explore the patterns and risk factors of early thyroid dysfunction in nasopharyngeal carcinoma (NPC) patients within 1 year after intensity‐modulated radiation therapy (IMRT). Methods: Patients with NPC who received definitive IMRT between April 2016 and April 2020 were included. All patients had normal thyroid function before definitive IMRT. The chi‐square test, Student's T‐test, Mann–Whitney U test, Kaplan–Meier method, receiver operating characteristics curve, and Cox proportional hazard analysis were used for statistical analysis. Results: A total of 132 NPC patients were identified. Of these patients, 56 (42.4%) had hypothyroidism and 17 (12.9%) had hyperthyroidism. The median time to hypothyroidism and hyperthyroidism was 9 months (range, 1–12 months) and 1 month (range, 1–6 months) after definitive IMRT, respectively. In patients with hypothyroidism, 41 (73.2%) had subclinical hypothyroidism and 15 (26.8%) had clinical hypothyroidism. In those with hyperthyroidism, 12 patients (70.6%) had subclinical hyperthyroidism, and five patients (29.4%) had clinical hyperthyroidism. Age, clinical stage, thyroid volume, and V45 were independent risk factors for early radiation‐induced hypothyroidism within 1 year after IMRT. Patients aged <47 years, stage III/IV disease, or pre‐irradiation thyroid volume < 14 cm3 had higher risks of developing hypothyroidism. Conclusion: Primary subclinical hypothyroidism was the most common subtype of early thyroid dysfunction in NPC patients within 1 year after IMRT. Age, clinical stage, thyroid volume, and V45 were independent risk factors for early radiation‐induced hypothyroidism in NPC patients.
- Subjects
THYROID diseases; NASOPHARYNX cancer; RECEIVER operating characteristic curves; MANN Whitney U Test
- Publication
Head & Neck, 2023, Vol 45, Issue 9, p2344
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.27448