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Related Experiment Videos

Thyroid function should be monitored following radiotherapy to the low neck.

Allie Garcia-Serra1, Robert J Amdur, Christopher G Morris

  • 1Department of Radiation Oncology, University of Florida, College of Medicine, Gainesville, FL 32610-0385, USA.

American Journal of Clinical Oncology
|June 1, 2005
PubMed
Summary

Radiotherapy to the neck frequently causes hypothyroidism, a condition affecting thyroid function. Regular thyroid stimulating hormone (TSH) monitoring is recommended for head and neck cancer patients post-treatment to detect this common side effect.

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiotherapy

Background:

  • Head and neck cancer radiotherapy (RT) can impact thyroid function.
  • Hypothyroidism is a potential long-term side effect of RT to the low neck region.
  • Routine thyroid function monitoring in asymptomatic patients is debated.

Purpose of the Study:

  • To assess the incidence of hypothyroidism after low neck radiotherapy.
  • To determine if routine thyroid function monitoring is justified in asymptomatic patients.
  • To identify factors predicting hypothyroidism development post-RT.

Main Methods:

  • Retrospective study of 504 head and neck cancer patients treated with RT including the thyroid gland.
  • Hypothyroidism defined as thyroid stimulating hormone (TSH) > or =4.5 mIU/L.

Related Experiment Videos

  • Analysis of actuarial freedom from hypothyroidism and predictive factors.

    • Main Results:

    • Biochemical hypothyroidism developed in at least 50% of patients.
    • Actuarial freedom from hypothyroidism was 51% at 10 years in the entire cohort.
    • Definitive surgery involving thyroid removal and overall cancer stage were significant predictors of hypothyroidism.

    Conclusions:

    • Head and neck irradiation leads to a high incidence of hypothyroidism.
    • Regular thyroid function testing is crucial for patients treated with RT to the low neck.
    • TSH monitoring every 6 months for 5 years, then annually, is recommended, with hormone replacement initiated for TSH >4.5 mIU/L.