甲状腺功能减退症对接受调强放疗的鼻咽癌患者的预后价值。

Prognostic value of hypothyroidism in patients undergoing intensity-modulated radiation therapy for nasopharyngeal carcinoma.

机构信息

Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China.

Department of Laboratory Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China.

出版信息

Head Neck. 2022 May;44(5):1114-1123. doi: 10.1002/hed.27006. Epub 2022 Feb 16.

DOI:10.1002/hed.27006

PMID:35170140

Abstract

BACKGROUND

The purpose of this study was to investigate the effect of hypothyroidism and thyroxine replacement therapy on the prognosis of nasopharyngeal carcinoma (NPC) patients.

METHODS

The clinical data of 284 NPC patients, who received intensity-modulated radiation therapy (IMRT) between January 2011 and December 2016, were retrospectively analyzed.

RESULTS

Hypothyroidism occurred in 38% of patients. Patients with hypothyroidism had significantly better disease-free survival (DFS) (p = 0.002) and relapse-free survival (RFS) (p = 0.008). Multivariate analysis showed that hypothyroidism was a positive independent prognostic factor (DFS and RFS). Among the patients with hypothyroidism, thyroxine replacement therapy did not yield inferior survival (DFS, RFS, all p > 0.05).

CONCLUSIONS

The NPC patients with complete response are at risk of hypothyroidism, which is attributable to escalating dose. These patients experienced clinical hypothyroidism could be adequately treated with thyroid hormone replacement. Further investigation of the underlying biological mechanism and potential therapeutic implications are required.

摘要

背景

本研究旨在探讨甲状腺功能减退症及甲状腺素替代治疗对鼻咽癌（NPC）患者预后的影响。

方法

回顾性分析了 284 例于 2011 年 1 月至 2016 年 12 月接受调强放疗（IMRT）的 NPC 患者的临床资料。

结果

38%的患者发生甲状腺功能减退症。发生甲状腺功能减退症的患者无病生存率（DFS）（p=0.002）和无复发生存率（RFS）（p=0.008）显著提高。多因素分析显示，甲状腺功能减退症是一个阳性独立预后因素（DFS 和 RFS）。在发生甲状腺功能减退症的患者中，甲状腺素替代治疗并未导致生存不良（DFS、RFS，均 p＞0.05）。