Grande C
Department of Radiation Oncology, Asturias General Hospital, Oviedo, Spain.
Radiother Oncol. 1992 Sep;25(1):31-6. doi: 10.1016/0167-8140(92)90192-w.
The incidence of hypothyroidism following radiotherapy for head and neck cancer is 10-45% in several series. In order to identify possible risk factors a multivariate analysis was performed in 221 patients previously treated with either radiotherapy alone or combined with surgery or chemotherapy. Diagnostic procedures included: total T3 and T4, free T4 and TSH measured by radioimmunoassay, and thyroid scintigraphy. The absolute rate of hypothyroidism was 41.17% (subclinical 26.24%, clinical 14.93%). No thyroid nodules were detected in any patient. By multivariate analysis, risk factors that significantly influenced a higher incidence of hypofunction were: high radiation dose (p = 0.000), combination of radiotherapy and cervical surgery (p = 0.003), time from therapy (p = 0.022) and no shielding of midline (p = 0.026).
在多个系列研究中，头颈部癌放疗后甲状腺功能减退的发生率为10% - 45%。为了确定可能的风险因素，对221例先前接受单纯放疗或放疗联合手术或化疗的患者进行了多因素分析。诊断方法包括：采用放射免疫分析法测定总T3、总T4、游离T4和促甲状腺激素（TSH），以及甲状腺闪烁显像。甲状腺功能减退的绝对发生率为41.17%（亚临床型26.24%，临床型14.93%）。所有患者均未检测到甲状腺结节。多因素分析显示，显著影响甲状腺功能减退发生率升高的风险因素为：高辐射剂量（p = 0.000）、放疗与颈部手术联合（p = 0.003）、治疗后的时间（p = 0.022）以及中线未屏蔽（p = 0.026）。
