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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2011; 32(03): 143-148
DOI: 10.4103/0971-5851.92813
ORIGINAL ARTICLE

How common is hypothyroidism after external radiotherapy to neck in head and neck cancer patients?

Nirmala Srikantia
Department of Radiotherapy, MS Ramaiah Medical College, Bengaluru, Karnataka, India
,
Karthik S Rishi
Department of Radiotherapy, Manipal Hospital, Bengaluru, Karnataka, India
,
M G Janaki
Department of Radiotherapy, MS Ramaiah Medical College, Bengaluru, Karnataka, India
,
Ramesh S Bilimagga
Department of Radiotherapy, MS Ramaiah Medical College, Bengaluru, Karnataka, India
,
Arul Ponni
Department of Radiotherapy, MS Ramaiah Medical College, Bengaluru, Karnataka, India
,
A G Rajeev
Department of Radiotherapy, MS Ramaiah Medical College, Bengaluru, Karnataka, India
,
Kirthi Kaushik
Department of Radiotherapy, MS Ramaiah Medical College, Bengaluru, Karnataka, India
,
Mala Dharmalingam
Department of Endocrinology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
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Abstract

Purpose: To identify the occurrence of clinical and subclinical hypothyroidism among head and neck cancer patients receiving radiation to the neck and to justify routine performing of thyroid function tests during follow-up. Materials and Methods: This is a prospective nonrandomized study of 45 patients of head and neck cancer, receiving radiotherapy (RT). Thyroid stimulating hormone and T4 estimations were done at baseline and at 4 months and 9 months following RT. Results: Of the 45 patients, 37(82.2 %) were males and eight (17.8 %) were females. All patients received radiation to the neck to a dose of >40Gy. 35.6% received concurrent chemotherapy. Two patients underwent prior neck dissection. Fourteen patients (31.1%) were found to have clinical hypothyroidism (P value of 0.01). Five (11.1%) patients were found to have subclinical hypothyroidism with a total 19 of 45 (42.2%) patients developing radiation-induced hypothyroidism. Nine of 14 patients with clinical hypothyroidism were in the age group of 51 to 60 years (P=0.0522). Five of 16 patients who received chemoradiation and nine of 29 who received RT alone developed clinical hypothyroidism. Above 40 Gy radiation dose was not a relevant risk factor for hypothyroidism. Conclusion: Hypothyroidism (clinical or subclinical) is an under-recognized morbidity of external radiation to the neck which is seen following a minimum dose of 40 Gy to neck. Recognizing hypothyroidism (clinical or subclinical) early and treating it prevents associated complications. Hence, thyroid function tests should be made routine during follow-up.

Keywords

Head and neck cancer - hypothyroidism - radiotherapy - subclinical hypothyroidism


Publication History

Article published online:
06 August 2021

© 2011. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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