Abstract
BackgroundWe investigated the risk factors of radiation-induced thyroid dysfunction, then combined the clinical factors and optimum thyroid dosimetric parameters to predict the incidence rate of hypothyroidism (HT) and to guide individualized treatment.MethodsA total of 206 patients with histologically proven nasopharyngeal carcinoma (NPC) treated at the Cancer Hospital of the University of Chinese Academy of Sciences between January 2015 and August 2018 were included. Dose–volume histogram (DVH) data, including mean dose, absolute volume, V20, V25, V30, V35, V40, V45, V50, V55, and V60 were extracted and used as dosimetric parameters. A logistic regression analysis model was built to identify predictors related to HT occurring within 2 years.ResultsSex, N stage, thyroid volume, mean thyroid dose, and thyroid V20 and V50 were significantly different between patients with and without HT. Logistic regression analysis showed that N stage, thyroid volume, and thyroid V50 were independent predictors of HT. The radiosensitivity of the thyroid decreased as the thyroid volume increased. Patients with N stage > 1 had significantly higher HT incidence (37.38%) than patients with N stage ≤1 (13.11%). The incidence of HT was 54.55% in patients with thyroid V50 > 24% and was 34.15% in patients with thyroid V50 ≤ 24%.ConclusionsThe incidence of HT is significantly associated with N stage, thyroid volume, and thyroid V50. More attention should be paid to patients with NPC with thyroid volume ≤ 12.82 cm3 and advanced N stage disease.
Highlights
We investigated the risk factors of radiation-induced thyroid dysfunction, combined the clinical factors and optimum thyroid dosimetric parameters to predict the incidence rate of hypothyroidism (HT) and to guide individualized treatment
Many studies have focused on the factors affecting thyroid function; the impact of radiation on HT related to the thyroid and pituitary glands remains poorly understood, and the incidence of HT has not been controlled effectively in patients with Nasopharyngeal carcinoma (NPC) post-intensity-modulated radiotherapy (IMRT) [14]
The purpose of the present study was to investigate the risk factors related to radiation-induced thyroid dysfunction, combine the clinical factors and optimum thyroid dosimetric parameters to predict the incidence of HT and guide individualized treatment
Summary
We investigated the risk factors of radiation-induced thyroid dysfunction, combined the clinical factors and optimum thyroid dosimetric parameters to predict the incidence rate of hypothyroidism (HT) and to guide individualized treatment. The incidence of HT in patients with NPC treated with IMRT ranges from 14.1 to 60% [8, 9], mostly occurring within 5 years after treatment. Many studies have focused on the factors affecting thyroid function; the impact of radiation on HT related to the thyroid and pituitary glands remains poorly understood, and the incidence of HT has not been controlled effectively in patients with NPC post-IMRT [14]. The purpose of the present study was to investigate the risk factors related to radiation-induced thyroid dysfunction, combine the clinical factors and optimum thyroid dosimetric parameters to predict the incidence of HT and guide individualized treatment
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