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喉癌和下咽癌初次手术治疗后的甲状腺功能减退症

Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer.

作者信息

Turgut Ozlem Kaya, Erişen Levent, Coşkun Hakan, Basut Oğuz, Onart Selçuk, Hizalan Ibrahim

机构信息

Department of Otolaryngology, Medicine Faculty of Uludağ University, Bursa, Turkey.

出版信息

Kulak Burun Bogaz Ihtis Derg. 2008 May-Jun;18(3):125-30.

Abstract

OBJECTIVES

We investigated the incidence of hypothyroidism after treatment of laryngeal or hypopharyngeal cancer (LHC), and evaluated its relationship with treatment modalities.

PATIENTS AND METHODS

Thyroid functions of 42 patients (41 males, 1 female; mean age 58 years; range 35 to 81 years) undergoing surgical treatment with (74%) or without adjuvant radiotherapy for LHC were prospectively evaluated preoperatively, on the 15th day, and in the sixth month postoperatively. The results were compared in relation to the treatment methods employed.

RESULTS

The overall incidence of post-treatment hypothyroidism was 23.8%. Five patients had hypothyroidism in the early postoperative period, and this number increased to 10 after six months. All patients with hypothyroidism had undergone total laryngectomy with bilateral neck dissection, followed by radiotherapy. A significantly higher incidence of hypothyroidism was associated with total laryngectomy, bilateral neck dissection, level VI dissection, partial or bilateral thyroidectomy, adjuvant radiotherapy, and upper mediastinal radiotherapy.

CONCLUSION

The incidence of post-treatment hypothyroidism is not rare in LHC patients, requiring long-term monitoring of thyroid functions to prevent associated morbidities.

摘要

目的

我们调查了喉癌或下咽癌(LHC)治疗后甲状腺功能减退症的发生率,并评估了其与治疗方式的关系。

患者与方法

对42例接受LHC手术治疗(74%)或未接受辅助放疗的患者(41例男性,1例女性;平均年龄58岁;范围35至81岁)的甲状腺功能在术前、术后第15天和术后第六个月进行前瞻性评估。将结果与所采用的治疗方法进行比较。

结果

治疗后甲状腺功能减退症的总体发生率为23.8%。5例患者在术后早期出现甲状腺功能减退,6个月后这一数字增至10例。所有甲状腺功能减退患者均接受了全喉切除术加双侧颈部清扫术,随后进行放疗。甲状腺功能减退症的发生率显著升高与全喉切除术、双侧颈部清扫术、Ⅵ区清扫术、部分或双侧甲状腺切除术、辅助放疗和上纵隔放疗有关。

结论

LHC患者治疗后甲状腺功能减退症的发生率并不罕见,需要长期监测甲状腺功能以预防相关并发症。

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