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Hypothyroidism in patients with colorectal carcinoma treated with fluoropyrimidines

Yutaka Fujiwara1, Naoko Chayahara, Toru Mukohara

  • 1Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan.

Oncology Reports
|August 1, 2013
PubMed

Insights

Fluoropyrimidines, used in colorectal cancer chemotherapy, can cause thyroid dysfunction. Bevacizumab did not impact thyroid function in this study, but further research is needed on fluoropyrimidine mechanisms.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Targeted therapies, including tyrosine kinase inhibitors, are known to cause hypothyroidism and thyroid dysfunction.
  • Thyroid dysfunction in cancer patients may be underdiagnosed and undertreated.
  • Colorectal cancer patients receiving chemotherapy require monitoring for thyroid function.

Purpose of the Study:

  • To evaluate thyroid function in colorectal cancer patients undergoing fluoropyrimidine-based chemotherapy with or without bevacizumab.
  • To determine the impact of bevacizumab and fluoropyrimidines on thyroid function.
  • To identify the incidence of chemotherapy-induced thyroid dysfunction.

Main Methods:

  • Thyroid function was assessed at baseline and monthly in colorectal cancer patients.
  • Thyroid-stimulating hormone (TSH) levels were monitored.
  • Patients received fluoropyrimidine-based chemotherapy with or without bevacizumab.

Main Results:

  • 11.1% of patients developed TSH levels >10 µU/ml, and 48.1% had elevated TSH.
  • No significant difference in TSH elevation was observed between the bevacizumab and chemotherapy-alone groups.
  • Three patients developed TSH >10 µU/ml; two with hypothyroidism received thyroid hormone replacement.

Conclusions:

  • Bevacizumab does not appear to affect thyroid function in colorectal cancer patients.
  • Fluoropyrimidines may induce thyroid dysfunction in patients with colorectal cancer.
  • Further research is necessary to elucidate the mechanism of fluoropyrimidine-induced thyroid dysfunction.

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