[Hypothyroidism following combined treatment of pharyngolaryngeal carcinoma].

The onset of hypothyroidism following surgery and/or radiotherapy for head and neck cancer varies from 25 to 67% and it is fostered by some clinical conditions. However, these percentages increase when one takes into consideration the latent hypofunctioning brought about by high levels of T.S.H. The present case study involves 15 laryngeal or pharyngolaryngeal cancer patients: 3 had undergone surgery alone although most of them had received a combination of radiotherapy and surgery. For these patients both the clinical conditions of any hypothyroidism and the laboratory parameters for thyroid function were studied. Of these the most significant proved to be T.S.H. The patients were monitored at 4 month intervals over the course of a year. In three of the 15 pharyngolaryngeal cancer subjects who had undergone a combined treatment including surgery and radiotherapy comparison of the parameters studied proved statistically highly significant (with an increase in T.S.H.). The damage sustained does not so much depend on the total dose of radiation but rather on the number of fractions employed. It may, therefore, be suggested that making changes in surgery to the detriment of oncological radicality is not worth while. It would appear that a different scheme for distribution of radiotherapy doses should, rather, be devised.