Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients

Yuan-Hua Wu, Hung Ming Wang, Helen H.W Chen, Chien Yu Lin, Eric Yen Chao Chen, Kang Hsing Fan, Shiang Fu Huang, I. How Chen, Chun Ta Liao, Ann Joy Cheng, Joseph Tung Chieh Chang

Research output: Contribution to journalArticle

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Abstract

Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3%, 9.0%, and 19.1% at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1% experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.

Original languageEnglish
Pages (from-to)1133-1139
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume76
Issue number4
DOIs
Publication statusPublished - 2010 Mar 15

Fingerprint

Nasopharyngeal Neoplasms
Hypothyroidism
radiation therapy
Radiotherapy
cancer
hormones
therapy
incidence
Thyrotropin
Incidence
Thyroid Gland
thyroxine
Therapeutics
chemotherapy
acceleration (physics)
Thyroxine
Thyroid Hormones
fractionation
serums
Neck

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Wu, Yuan-Hua ; Wang, Hung Ming ; Chen, Helen H.W ; Lin, Chien Yu ; Chen, Eric Yen Chao ; Fan, Kang Hsing ; Huang, Shiang Fu ; Chen, I. How ; Liao, Chun Ta ; Cheng, Ann Joy ; Chang, Joseph Tung Chieh. / Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients. In: International Journal of Radiation Oncology Biology Physics. 2010 ; Vol. 76, No. 4. pp. 1133-1139.
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abstract = "Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3{\%}, 9.0{\%}, and 19.1{\%} at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1{\%} experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.",
author = "Yuan-Hua Wu and Wang, {Hung Ming} and Chen, {Helen H.W} and Lin, {Chien Yu} and Chen, {Eric Yen Chao} and Fan, {Kang Hsing} and Huang, {Shiang Fu} and Chen, {I. How} and Liao, {Chun Ta} and Cheng, {Ann Joy} and Chang, {Joseph Tung Chieh}",
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Wu, Y-H, Wang, HM, Chen, HHW, Lin, CY, Chen, EYC, Fan, KH, Huang, SF, Chen, IH, Liao, CT, Cheng, AJ & Chang, JTC 2010, 'Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients', International Journal of Radiation Oncology Biology Physics, vol. 76, no. 4, pp. 1133-1139. https://doi.org/10.1016/j.ijrobp.2009.03.011

Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients. / Wu, Yuan-Hua; Wang, Hung Ming; Chen, Helen H.W; Lin, Chien Yu; Chen, Eric Yen Chao; Fan, Kang Hsing; Huang, Shiang Fu; Chen, I. How; Liao, Chun Ta; Cheng, Ann Joy; Chang, Joseph Tung Chieh.

In: International Journal of Radiation Oncology Biology Physics, Vol. 76, No. 4, 15.03.2010, p. 1133-1139.

Research output: Contribution to journalArticle

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T1 - Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients

AU - Wu, Yuan-Hua

AU - Wang, Hung Ming

AU - Chen, Helen H.W

AU - Lin, Chien Yu

AU - Chen, Eric Yen Chao

AU - Fan, Kang Hsing

AU - Huang, Shiang Fu

AU - Chen, I. How

AU - Liao, Chun Ta

AU - Cheng, Ann Joy

AU - Chang, Joseph Tung Chieh

PY - 2010/3/15

Y1 - 2010/3/15

N2 - Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3%, 9.0%, and 19.1% at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1% experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.

AB - Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3%, 9.0%, and 19.1% at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1% experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.

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