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下咽癌和喉癌动脉内化疗后的甲状腺功能障碍

Thyroid dysfunction after intra-arterial chemotherapy for hypopharyngeal and laryngeal cancer.

作者信息

Endo Kazuhira, Masatani Tomomi, Tsuji Akira, Kondo Satoru, Wakisaka Naohiro, Murono Shigeyuki, Yoshizaki Tomokazu

机构信息

Division of Otolaryngology, Graduate School of Medicine, Kanazawa University, Kanazawa 920-8640, Japan.

Division of Otolaryngology, Graduate School of Medicine, Kanazawa University, Kanazawa 920-8640, Japan.

出版信息

Auris Nasus Larynx. 2015 Jun;42(3):231-4. doi: 10.1016/j.anl.2014.12.002. Epub 2014 Dec 24.

DOI:10.1016/j.anl.2014.12.002
PMID:25544714
Abstract

OBJECTIVE

Hypothyroidism is a late side effect after curative radiotherapy in the head and neck region. Superselective intra-arterial chemotherapy (SSIAC), when combined with radiation (SSIAC-R), shows higher control potential for locally advanced head and neck cancers, which is attributable to a delivery of higher concentrations of chemotherapeutic agents. However, it could enhance damages in the normal tissues. Hypothyroidism is a late adverse effect after curative radiotherapy in the head and neck region. This study focuses on the toxic effect of treatment modality for thyroid function.

METHODS

A retrospective analysis was performed to examine patients' thyroid function after SSIAC-R for laryngeal and hypopharyngeal cancer.

RESULTS

Hypothyroidism was observed in 21 (77.8%) of 27 patients receiving SSIAC-R, 4 (33.3%) of 12 patients treated with radiation alone, and 7 (41.1%) of 17 who underwent systemic chemoradiotherapy. The number of administered vessels significantly correlated with the incidence of developing hypothyroidism among SSIAC-R treated patients (P=0.03).

CONCLUSION

Concurrent setting of SSIAC with radiation significantly raises the possibility of hypothyroidism. Therefore, monitoring late complications of therapeutic procedures is essential during follow-up visits.

摘要

目的

甲状腺功能减退是头颈部根治性放疗后的晚期副作用。超选择性动脉内化疗(SSIAC)与放疗联合(SSIAC-R)时,对局部晚期头颈部癌症显示出更高的控制潜力,这归因于更高浓度化疗药物的递送。然而,它可能会增加正常组织的损伤。甲状腺功能减退是头颈部根治性放疗后的晚期不良反应。本研究聚焦于治疗方式对甲状腺功能的毒性作用。

方法

进行回顾性分析,以检查接受SSIAC-R治疗喉癌和下咽癌患者的甲状腺功能。

结果

27例接受SSIAC-R治疗的患者中有21例(77.8%)出现甲状腺功能减退,12例单纯接受放疗的患者中有4例(33.3%)出现,17例接受全身放化疗的患者中有7例(41.1%)出现。在接受SSIAC-R治疗的患者中,给药血管数量与发生甲状腺功能减退的发生率显著相关(P=0.03)。

结论

SSIAC与放疗同时进行显著增加了甲状腺功能减退的可能性。因此,在随访期间监测治疗程序的晚期并发症至关重要。

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