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舌癌辅助治疗中的甲状腺功能减退症

Hypothyroidism in Carcinoma of the Tongue with Adjuvant Treatment.

作者信息

Kumari Sabita, Gondi Jonathan, Nemade Hemantkumar, Chandra Sekhara Rao L M, Gudipudi Deleep, Rao T Subramanyeshwar

机构信息

Department of Oral and Maxillofacial Surgery, Al Ameen Dental College, Bijapur, Karnataka, India.

Department of Surgical Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India.

出版信息

Rambam Maimonides Med J. 2017 Jul 31;8(3):e0031. doi: 10.5041/RMMJ.10290.

Abstract

OBJECTIVE

The objective of this study was to evaluate the incidence of hypothyroidism with adjuvant treatment in oral tongue carcinoma patients treated primarily with surgery.

MATERIALS AND METHODS

A retrospective review was carried out to analyze hypothyroidism incidence and its relation to adjuvant treatment (radiation/radio-chemotherapy) in oral tongue carcinoma after the primary surgical ablation and neck dissection. Hypothyroidism was analyzed in relation with dose of radiation, gender, and adjuvant treatment modality.

RESULTS

The study analyzed the patients who were treated between January 2012 and June 2015. Among 705 patients with carcinoma of the tongue treated primarily with wide local excision and neck dissection, 383 received adjuvant treatment. A total of 215 patients received radiation, and 168 received concurrent radio-chemotherapy. Of 378 patients, 78 developed hypothyroidism during follow-up: 27 patients received concurrent radio-chemotherapy, and the remaining 51 received only radiation. Lower neck received 40-48 Gy in 2 patients, 50 Gy in 74 patients, and 60-70 Gy and concurrent radio-chemotherapy in 27 patients. Median follow-up was 32 months. Hypothyroidism occurred in 21.5% of patients with squamous cell carcinoma of the oral tongue. The minimum period to develop hypothyroidism was 3 months in this study. Gender and adjuvant treatment were not found to be significant for the incidence of hypothyroidism.

CONCLUSIONS

A significant number of patients with carcinoma of the tongue who receive adjuvant treatment will develop hypothyroidism, hence frequent monitoring of thyroid function is advised during follow-up.

摘要

目的

本研究的目的是评估主要接受手术治疗的口腔舌癌患者辅助治疗后甲状腺功能减退的发生率。

材料与方法

进行回顾性分析,以分析口腔舌癌患者在初次手术切除和颈部清扫术后甲状腺功能减退的发生率及其与辅助治疗(放疗/放化疗)的关系。分析甲状腺功能减退与辐射剂量、性别和辅助治疗方式的关系。

结果

该研究分析了2012年1月至2015年6月期间接受治疗的患者。在705例主要接受广泛局部切除和颈部清扫的舌癌患者中,383例接受了辅助治疗。共有215例患者接受了放疗,168例接受了同步放化疗。在378例患者中,78例在随访期间出现甲状腺功能减退:27例接受同步放化疗,其余51例仅接受放疗。2例患者下颈部接受40 - 48 Gy照射,74例接受50 Gy照射,27例接受60 - 70 Gy照射及同步放化疗。中位随访时间为32个月。口腔舌鳞状细胞癌患者中21.5%发生甲状腺功能减退。本研究中出现甲状腺功能减退的最短时间为3个月。未发现性别和辅助治疗对甲状腺功能减退的发生率有显著影响。

结论

大量接受辅助治疗的舌癌患者会发生甲状腺功能减退,因此建议在随访期间频繁监测甲状腺功能。

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