Early and Long-Term Thyroid Dysfunction in Patients With Head and Neck Squamous Cell Carcinoma After External Radiotherapy: Clinicopathological Risk Factors.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-04-01 DOI:10.1002/hed.28150

Adriana Russo Fiore, Gustavo Jacob Lourenço, Eduardo Baldon Pereira, Luciana Freire De Almeida Dos Anjos, Carmen Silvia Passos Lima, Denise Engelbrecht Zantut-Wittmann

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引用次数: 0

Abstract

Background: To evaluate thyroid dysfunction(TD) among patients with head and neck squamous cell carcinoma (HNSCC) submitted to external radiotherapy (RT).

Methods: The study focused on early and long-term TD in 285 HNSCC patients treated with RT alone or combined with radiochemotherapy and/or surgery.

Results: A total of 156 (54.7%) patients presented TD during follow-up, 153 (53.7%) TD in long-term. Subclinical hypothyroidism (SCH) was the TD first identified in 43.5%; persisted in 68.5%, evolved to overt hypothyroidism in 21%, central hypothyroidism in 0.8%, returned to euthyroidism in 9.7%. TD first detection was 7.2 months after RT, 3.85 months for subclinical thyrotoxicosis, 17.77 months for SCH. Type 2 diabetes mellitus (DM2), metastatic lymph nodes, no tumor resection were TD risk factors. All patients with TSH ≥ 7.5 mIU/mL developed primary/SCH, 19.5% with TSH < 7.5 mIU/mL remained euthyroid at long-term follow-up.

Conclusion: Frequent monitoring of thyroid function is necessary in patients with HNSCC after RT, particularly with DM2, lymph node involvement, no surgical tumor resection.

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背景：评估头颈部鳞状细胞癌（HNSCC）患者的甲状腺功能障碍（TD）：评估接受体外放射治疗（RT）的头颈部鳞状细胞癌（HNSCC）患者的甲状腺功能障碍（TD）：研究重点是285例单独接受或联合放化疗和/或手术治疗的HNSCC患者的早期和长期甲状腺功能障碍：结果：共有156名（54.7%）患者在随访期间出现TD，153名（53.7%）患者在长期随访中出现TD。亚临床甲状腺功能减退症（SCH）是首次发现的甲状腺功能减退症，占43.5%；68.5%持续存在，21%演变为明显甲状腺功能减退症，0.8%为中枢性甲状腺功能减退症，9.7%恢复为甲状腺功能正常。TD首次发现时间为RT后7.2个月，亚临床甲亢为3.85个月，SCH为17.77个月。2型糖尿病（DM2）、转移性淋巴结、未切除肿瘤是TD的危险因素。TSH≥7.5 mIU/mL的所有患者均发展为原发性/SCH，TSH≥7.5 mIU/mL的患者占19.5%：RT后的HNSCC患者需要经常监测甲状腺功能，尤其是DM2、淋巴结受累、未手术切除肿瘤的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.