Radiation-Induced Hypothyroidism after Radical Intensity-Modulated Radiation Therapy for Oropharyngeal Carcinoma

Kamal, Mona; Peeler, C; Mohamed, A.S.R.; Frank, S.J.; Chen, L.; Jethanandani, Amit; Kuruvilla, Rohit; Greiner, Ben; Harp, J.; Granberry, R.; Mehta, Vivek; Rock, Calvin B.; Cárdenas, Carlos; Hutcheson, K.A.; Gunn, G.B.; Fuller, C.D.; Mirković, Dragan

doi:10.1016/j.ijrobp.2018.06.113

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“…A recent retrospective study of RIHT after IMRT in 360 OPC patients [ 21 ] reached similar conclusions to our study, i.e., that higher thyroid mean dose and smaller thyroid volume are both significantly associated with risk of RIHT in the multivariate analysis. The authors also recalibrated and evaluated two of the five already mentioned NTCP models, by Boomsma et al and by Cella et al, each yielding AUC ROC of 0.72 and 0.66, respectively.…”

Section: Discussionsupporting

confidence: 91%

Radiation-Induced Hypothyroidism in Patients with Oropharyngeal Cancer Treated with IMRT: Independent and External Validation of Five Normal Tissue Complication Probability Models

Nowicka

Tomasik

Papis-Ubych

et al. 2020

Cancers

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We aimed to externally validate five normal tissue complication probability (NTCP) models for radiation-induced hypothyroidism (RIHT) in a prospectively recruited cohort of 108 patients with oropharyngeal cancer (OPC). NTCP scores were calculated using original published formulas. Plasma thyrotropin (TSH) level was additionally assessed in the short-term after RT. After a median of 28 months of follow-up, thirty one (28.7%) patients developed RIHT. Thyroid mean dose and thyroid volume were significant predictors of RIHT: odds ratio equal to 1.11 (95% CI 1.03–1.19) for mean thyroid dose and 0.87 (95%CI 0.81–0.93) for thyroid volume in univariate analyses. Two of the evaluated NTCP models, published by Rønjom et al. and by Boomsma et al., had satisfactory performance with accuracies of 0.87 (95%CI 0.79–0.93) and 0.84 (95%CI: 0.76–0.91), respectively. Three remaining models, by Cella et al., Bakhshandeh et al. and Vogelius et al., performed significantly worse, overestimating the risk of RIHT in this patient cohort. A short-term TSH level change relative to baseline was not indicative of RIHT development in the follow-up (OR 0.96, 95%CI: 0.65–1.42, p = 0.825). In conclusion, the models by Rønjom et al. and by Boomsma et al. demonstrated external validity and feasibility for long-term prediction of RIHT in survivors of OPC treated with Intensity-Modulated Radiation Therapy (IMRT).

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Section: Discussionsupporting

confidence: 91%