Aich Ranen Kanti, Ranjan Deb Asit, Pal Santanu, Naha Biswas Litan, Amitabh Ray
Department of Radiotherapy of Nil Ratan Sircar Medical College & Hospital, 138, A.J.C. Bose Road, Kolkata - 700014, West-Bengal, India.
J Cancer Res Ther. 2005 Jul-Sep;1(3):142-6. doi: 10.4103/0973-1482.19593.
Hypothyroidism is a known consequence of external beam radiotherapy to the neck encompassing part or whole of the thyroid gland for over 40 years. Still thyroid function tests are not a part of routine follow up of head - neck cancer patients treated with radiotherapy with or without surgery and / or chemotherapy.
Aim of this study was to find out the incidence of hypothyroidism in head - neck cancer patients treated with radiotherapy with or without chemotherapy where radiation portals included most or whole of the thyroid gland.
From September 2001 to November 2003, 187 patients with head-neck malignancies were treated with external beam radiotherapy whose radiation portals included part or whole of the thyroid gland with / without chemotherapy. Thyroid function tests were done at the beginning of treatment, at six weeks after completion of radiotherapy and thereafter at six weeks interval for two years.
Out of 187 patients, five were excluded from the study as they were found to be hypothyroid before the initiation of treatment. Another four were excluded from result analysis because they underwent laryngectomy for uncontrolled disease. Of the patients attending the follow up clinic, 17.8 % and 21.8 % were found to have clinical and sub-clinical hypothyroidism at two year.
As a significant number of patients develop hypothyroidism following radiotherapy to the neck, thyroid function tests should be included in the routine follow up protocol of such patients. But certain questions have emerged from this study which need a large randomized study to find out the answers.
40多年来，颈部接受包括部分或全部甲状腺的外照射放疗已知会导致甲状腺功能减退。然而，甲状腺功能检查仍未成为接受放疗（无论是否联合手术和/或化疗）的头颈癌患者常规随访的一部分。
本研究的目的是找出接受放疗（无论是否联合化疗）且照射野包括大部分或全部甲状腺的头颈癌患者中甲状腺功能减退的发生率。
2001年9月至2003年11月，187名头颈恶性肿瘤患者接受了外照射放疗，其照射野包括部分或全部甲状腺，同时接受或未接受化疗。在治疗开始时、放疗结束后六周以及此后两年内每六周进行一次甲状腺功能检查。
187名患者中，有5名在治疗开始前被发现患有甲状腺功能减退，因此被排除在研究之外。另外4名因疾病控制不佳接受了喉切除术，也被排除在结果分析之外。在随访门诊的患者中，两年时发现17.8%和21.8%的患者分别患有临床甲状腺功能减退和亚临床甲状腺功能减退。
由于大量患者在颈部放疗后会出现甲状腺功能减退，因此甲状腺功能检查应纳入此类患者的常规随访方案。但本研究也出现了一些问题，需要进行大规模随机研究以找到答案。
