Hypothyroidism in postradiation head and neck cancer patients: incidence, complications, and management

Abstract

To describe the incidence, risk factors, prevention, and management of hypothyroidism among patients treated with radiation and other modalities for head and neck cancers. Hypothyroidism may occur in up to 48% of patients treated for head and neck malignancies. It has been observed after radiation, surgery, and combined-modality therapies. The onset of hypothyroidism may be as early as 4 weeks and as late as 5 or 10 years after completion of therapy. It has been associated with poor wound healing, bleeding disorders, and a number of other potential complications germane to the practice of head and neck surgery. There is some evidence to suggest a protective role of hypothyroidism with respect to disease control survival in head and neck and other cancers. Hypothyroidism is common after treatment of head and neck cancers. Thyroid function studies should be obtained prior to and at regular intervals after treatment. Prompt recognition and intervention may prevent or reverse adverse physiological outcomes. Further studies are necessary to evaluate the role of permissive hypothyroidism in the context of treated head and neck malignancies.