Radiation induced hypothyroidism – Why is early intervention necessary?

Aggarwal, Kshitij; Thakur, S.; Rao, Vishal; Shetty, Sameep S.

doi:10.1016/j.oraloncology.2019.104444

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…One interesting question that arises for patients being treated with concurrent radiation therapy and immunotherapy is when to begin TSH screening and how aggressively to treat subclinical hypothyroidism. Transient TSH elevations have frequently been detected during radiation therapy to the head and neck with some authors suggesting TSH monitoring following HNSCC therapy should not begin until 2 to 6 months post‐treatment for this reason 25 . In contrast, the highest risk for immunotherapy‐mediated hypothyroidism occurs in the first few months of therapy.…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism in Head and Neck Squamous Cell Carcinoma Patients Receiving Radiotherapy With or Without Immune Checkpoint Inhibitors

et al. 2021

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Objectives/Hypothesis Hypothyroidism is a relatively common complication of head and neck squamous cell carcinoma (HNSCC) treatment. The objective of this study was to determine whether the addition of programmed death ligand‐1 (PD‐1) or programmed death ligand‐1 (PD‐L1) inhibition (anti‐PD‐1/PD‐L1 therapy) to standard treatment increases the risk of hypothyroidism in HNSCC. Study Design Retrospective Cohort. Methods This is a retrospective, single institutional cohort study. Patients who received radiotherapy (RT) for HNSCC were identified in the electronic medical record. Patient factors collected include age, sex, body mass index (BMI), smoking status, alcohol use, Charlson comorbidity index, and HNSCC treatment records. The rate of hypothyroidism for patients with HNSCC receiving RT (+/− chemotherapy and surgery) (RT group, n = 101) was compared to that of HNSCC patients receiving RT (+/− chemotherapy and surgery) + anti‐PD‐1/PD‐L1 therapy, either concurrently or after RT (RT + anti‐PD‐1/PD‐L1 group, n = 38). Results There was no significant difference in the rate of clinical or subclinical hypothyroidism between the two groups. Multinomial logistic regression found no significant difference in hypothyroidism based on age, sex, or BMI. Conclusions The addition of anti‐PD‐1/PD‐L1 therapy to standard HNSCC treatment does not significantly increase the risk of developing hypothyroidism. Level of Evidence 3 Laryngoscope, 131:E2413–E2419, 2021

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Section: Discussionmentioning

confidence: 99%

Hypothyroidism in Head and Neck Squamous Cell Carcinoma Patients Receiving Radiotherapy With or Without Immune Checkpoint Inhibitors

et al. 2021

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“…Hypothyroidism increases the risk of atherosclerosis [ 4 ], thereby increasing the incidence and mortality of cardiovascular and cerebrovascular diseases and ultimately greatly reducing the quality of life of patients [ 5 – 7 ]. According to relevant literature reports, the incidence of hypothyroidism 2 years after radiotherapy is 40% to 50%, of which subclinical hypothyroidism accounts for 70% and clinical hypothyroidism accounts for 30% [ 8 ]. The 2010 quantitative analysis report of clinical normal tissue effects did not mention the limiting dose of the thyroid gland [ 9 ]; thus, many studies are currently devoted to exploring the risk factors for hypothyroidism after radiotherapy for HNC and establishing normal tissue complication probability to ensure a limited dose of the thyroid.…”

Section: Introductionmentioning

confidence: 99%

Analysis of correlative risk factors for radiation-induced hypothyroidism in head and neck tumors

Wang,

Hou,

Wang

et al. 2024

BMC Cancer

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Objective The aim of the study is to identify clinical and dosimetric factors that could predict the risk of radiation-induced hypothyroidism(RIHT) in head and neck cancer(HNC) patients following intensity-modulated radiotherapy(IMRT). Methods A total of 103 HNC patients were included in our study. General clinical characteristic and dosimetric data of all recruited patients were analyzed, respectively. The univariate and multivariate logistic regression anlalysis were successively conducted to identify optimal predictors, which aim to construct the nomogram. And the joint prediction was performed. Results The incidence of patients with HNC was 36.9% (38/103). Among the clinical factors, gender, N stage, chemotherapy, frequency of chemotherapy and surgery involving the thyroid were related to RIHT. Logistic regression analysis showed that thyroid volume, Dmean, VS45, VS50, VS60 and V30,60 were independent predictors of RIHT, which were also incorporated in the nomogram. An AUC of 0.937 (95%CI, 0.888–0.958) also was showed outstanding resolving ability of the nomogram. When the volume of the thyroid was greater than 10.6 cm3, the incidence of RIHT was 14.8%, and when the volume of the thyroid was equal to or smaller than 10.6 cm3, the incidence was 72.5%. The incidence rates of RIHT in the group with VS60≦8.4cm3 and VS60 > 8.4cm3 were 61.4% and 19.3%, respectively. Conclusions Thyroid volume and thyroid VS60 are independent predictors of RIHT in patients with HNC. Moreover, more attention should be paid to patients with thyroid volume ≤ 10.6cm3. Thyroid VS60 > 8.4cm3 may be a useful threshold for predicting the development of RIHT. The nomogram conducted by the research may become a potential and valuable tool that could individually predict the risk of RIHT for HNC patients.

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“…The treatment options for these cancers include surgery, radiation therapy, chemotherapy, or a combination of the above. For advanced head and neck squamous cell carcinoma (HNSCC), radiotherapy is often employed in either definitive or adjuvant settings [2]. Historically, modalities of radiation delivery lacked high selectivity, making it difficult to avoid healthy tissues and non-target organs within the head and neck region.…”

Section: Introductionmentioning

confidence: 99%

Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study

Damico

Healy

et al. 2021

Technical Innovations & Patient Support in Radiation Oncolo

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Radiation induced hypothyroidism – Why is early intervention necessary?

Cited by 5 publications

References 17 publications

Hypothyroidism in Head and Neck Squamous Cell Carcinoma Patients Receiving Radiotherapy With or Without Immune Checkpoint Inhibitors

Hypothyroidism in Head and Neck Squamous Cell Carcinoma Patients Receiving Radiotherapy With or Without Immune Checkpoint Inhibitors

Analysis of correlative risk factors for radiation-induced hypothyroidism in head and neck tumors

Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study

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