Severe Hypothyroidism After Chemotherapy and Locoregional Irradiation for Breast Cancer

Cutuli, B.; Quétin, Philippe; Rodier, Jean-Francois; P, Barakat; Grob, Jean-Jacques

doi:10.1016/s0167-8140(00)00183-3

Cited by 38 publications

(30 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cutuli et al reported a recent case series of 80 breast cancer patients who underwent radiation therapy, chemotherapy, and surgery and found that 6.2% had clinically symptomatic hypothyroidism on short-term follow-up after primary treatment. 17 However, their analysis was limited by a small sample size, lack of a comparison group (ie, patients not treated with radiation), and lack of data on history of hypothyroidism. In addition, their study did not report long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Risk of hypothyroidism in older breast cancer patients treated with radiation

Smith

Giordano

et al. 2008

Cancer

View full text Add to dashboard Cite

BACKGROUND. Hypothyroidism is a potential complication after radiation therapy (RT) when treatment fields include the thyroid. The authors assessed risk of hypothyroidism in breast cancer patients who were receiving RT to a supraclavicular field, which typically includes a portion of thyroid. METHODS. The authors identified 38,255 women (aged >65) without history of hypothyroidism from the Surveillance, Epidemiology, and End Results (SEER)‐Medicare cohort diagnosed with stage 0‐III breast cancer from 1992–2002 and 111,944 cancer‐free controls. The authors compared hypothyroidism incidence among irradiated patients with 4 + positive lymph nodes (4 + LN, surrogate for supraclavicular RT) and no positive nodes (0 LN, surrogate for no supraclavicular RT), nonirradiated patients, and controls. Proportional hazards models tested associations of LN, RT, and breast cancer status with hypothyroidism. RESULTS. The 5‐year incidence of hypothyroidism was identical (14%) in irradiated patients with 4 + LN, 0 LN, and nonirradiated patients (P = .52). After adjusting for sociodemographic and clinical characteristics, hypothyroidism risk was not increased in irradiated patients with 4 + LN versus 0 LN (hazard ratio(HR) = 1.04; 95% confidence interval (CI), 0.89–1.23). However, all patients, regardless of RT status, were more likely to be diagnosed with hypothyroidism compared with cancer‐free controls (HR = 1.21; 95% CI, 1.17–1.25). CONCLUSIONS. Development of hypothyroidism is fairly common in older breast cancer survivors. Although supraclavicular irradiation does not appear to amplify risks, further studies on the role of routine thyroid function monitoring in all breast cancer patients regardless of treatment status may be warranted, given the excess risks compared with the general population. Cancer 2008. ©2008 American Cancer Society.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk of hypothyroidism in older breast cancer patients treated with radiation

Smith

Giordano

et al. 2008

Cancer

View full text Add to dashboard Cite

show abstract

“…Conflicting evidence has been published on the possible effect of precancer TD on the development of BC (1)(2)(3)(4)(5)(6)(7). Furthermore, it has been debated whether BC by itself may induce TD or to what degree different BC treatments (radiotherapy [RT], chemotherapy, and antiestrogens) may alter thyroid function (8)(9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

Reinertsen

Cvancarova

Wist

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

“…Other reports similarly indicate that radiation-induced changes in thyroid function initially manifested within 3 to 6 months after RT. [21][22][23] The time to development of HT has not been con- International Journal of Hematology and Oncology clusively defined. Prospective trials have been conducted in an attempt to answer this question.…”

mentioning

confidence: 99%

“…12,14,21,27 However, some studies suggest that addition of chemotherapy does not increase the risk of development of HT. 4,5,25,28 İn review, Jereczek-Fossa stated that the impact of chemotherapy and endocrine treatments on the risk of HT is still controversial.…”

mentioning

confidence: 99%

Thyroid Dysfunction Following Supraclavicular Irradiation in The Management of Carcinoma of the Breast.

Akyürek¹

2014

UHOD

View full text Add to dashboard Cite

Radiation induced thyroid dysfunction is usually underestimated in patients with breast cancer who had supraclavicular irradiation (RT). In the present study, a total of 28 patients with breast cancer received supraclavicular RT were evaluated focusing on radiation dose-volume factors in relation to thyroid function. Thyroid function tests, including serum thyroid stimulating hormone, free thyroxine, free triiodothyronine, were analyzed prior to RT and 3,6,9,12,18 and 24 months after RT. Based on each patient's dose volume histogram (DVH), total volume of the thyroid, mean radiation dose the thyroid and percentages of thyroid volume which received radiation doses 10-50 Gy (V10-V50) were considered for statistical analysis. The median follow-up time was 25 months (range, 12.3-36 months). Of 28 patients 6 (21%) were diagnosed with hypothyroidism (HT). The median time to the development of HT was 9 months (range: 3-18 months). Mean thyroid dose was 31 Gy (19-48 Gy) and mean thyroid volume was 32 cc (12-64 cc). We found that V20 (OR= 10, 95% CI= 1.15-86.88, p= 0.05), V30 (OR= 10, 95% CI= 1.15-86.88, p= 0.05) and V40 (OR= 21, 95% CI= 1.61-273.34, p= 0.02) and mean thyroid dose ≥36 Gy (OR= 10, 95% CI= 1.15-86.88) (p= 0.05), had a significant impact on development of HT. Moreover, significant elevation was observed in mean TSH level between baseline (1.85±1.47 mIU/L) and at 6 months (3.80±7.42 mIU/L), (p= 0.003). Supraclavicular RT in patients with breast cancer appear to amplify the risk of HT. We believe further investigations in larger cohort are required to confirm our results. Keywords: Thyroid dysfunction, Breast Cancer, Radiotherapy ÖZET Meme Kanserinde Supraklavikuler Işınlama Sonrası Tiroid Fonksiyon BozukluğuSupraklavikuler radyoterapi (RT) alan meme kanserli hastalarada tiroid fonksiyon bozuklukları genellikle göz ardı edilir. Bu çalışmada supraklavikuler RT alan 28 meme kanserli hasta, radyasyon doz-volüm faktörleri ve tiroid fonksiyon testlerine fokuslanarak değerlendirildi. Tiroid stümülan hormon, serbest triiyodotironin, serbest tiroksin, RT'den önce ve 3, 6, 9,12,18 ve 24 sonra analiz edildi. Tüm hastaların doz-volüm histogramlarına (DVH) dayanarak total tiroid volümü, mean tiroid dozu ve 10-50 Gy radyasyon alan tiroid volüm yüzdesi (V10-50) istatiksel analiz için elde edildi. Ortalama takip süresi 25 aydı (12.3-36 ay). Yirmisekiz hastanın 6 (%21)'sında hipotiroidizm (HT) saptandı. Median HT gelişme zamanı 9 (3-18 ay) aydı. Mean tiroid dozu 31 Gy (19-48 Gy) ve mean tiroid volümü 32 cc (12-64 cc) idi. V20 (OR= 10, 95% CI= 1.15-86.88, p= 0.05), V30 (OR= 10, 95% CI= 1.15-86.88, p= 0.05) ve V40 (OR= 21, 95% CI= 1.61-273.34, p= 0.02) ile mean tiroid dozunun ≥36 Gy (OR= 10, 95% CI= 1.15-86.88) (p= 0.05) olması HT gelişiminde anlamlı bulundu. Ek olarak, bazal mean TSH (1.85±1.47 mIU/L) düzeyi ile karşılaştırıldığında 6. ayda (3.80±7.42 mIU/L), (p= 0.003) anlamlı fark gözlendi. Meme kanserli hastalarda supraklaviküler RT, HT riskini artırıyor görünmektedir. Sonuçlarımızın daha fazla hasta sayılı çalışma...

show abstract

Severe Hypothyroidism After Chemotherapy and Locoregional Irradiation for Breast Cancer

Cited by 38 publications

References 5 publications

Risk of hypothyroidism in older breast cancer patients treated with radiation

Risk of hypothyroidism in older breast cancer patients treated with radiation

Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

Thyroid Dysfunction Following Supraclavicular Irradiation in The Management of Carcinoma of the Breast.

Contact Info

Product

Resources

About