Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Statistics, Pusan National University, Busan, Korea.
PLoS One. 2022 Jun 16;17(6):e0269893. doi: 10.1371/journal.pone.0269893. eCollection 2022.
This Korean population-based study aimed to describe the patterns of hypothyroidism after adjuvant radiation therapy (RT) in patients with breast cancer. The Korean Health Insurance Review and Assessment Service database was searched for patients with invasive breast carcinomas. We calculated the cumulative incidence and incidence rates per 1,000 person-years of subsequent hypothyroidism and compared them using the log-rank test and the Cox proportional hazards model. Between 2007 and 2018, 117,135 women diagnosed with breast cancer with a median follow-up time of 4.6 years were identified. The 8-year incidence of hypothyroidism was 9.3% in patients treated with radiation and 8.6% in those treated without radiation (p = 0.002). The incidence rates per 1,000 person-years in the corresponding treatment groups were 6.2 and 5.7 cases, respectively. The hazard ratio (HR) in patients receiving RT was 1.081 (95% confidence interval [CI], 1.013-1.134; p = 0.002). After mastectomy, RT showed a trend toward a higher risk of hypothyroidism (HR = 1.248; 95% CI, 0.977-1.595; p = 0.076). Our study provides one of the largest population-based data analyses regarding the risk of hypothyroidism among Korean patients with breast cancer. The adjusted risk for patients treated with RT exceeded that for patients with breast cancer treated without RT. The effect was evident immediately after treatment and lasted up to approximately 9 years.
这项基于韩国人群的研究旨在描述乳腺癌患者接受辅助放疗 (RT) 后甲状腺功能减退症的发生模式。我们在韩国健康保险审查和评估服务数据库中检索了浸润性乳腺癌患者。我们计算了随后发生甲状腺功能减退症的累积发生率和每 1000 人年的发病率，并使用对数秩检验和 Cox 比例风险模型进行了比较。在 2007 年至 2018 年间，共确定了 117135 名患有乳腺癌的女性，中位随访时间为 4.6 年。接受放疗的患者 8 年甲状腺功能减退症的发病率为 9.3%，未接受放疗的患者为 8.6%（p = 0.002）。相应治疗组的每 1000 人年发病率分别为 6.2 和 5.7 例。接受 RT 的患者的风险比 (HR) 为 1.081（95%置信区间 [CI]，1.013-1.134；p = 0.002）。在乳房切除术之后，RT 显示出甲状腺功能减退症风险升高的趋势（HR = 1.248；95%CI，0.977-1.595；p = 0.076）。我们的研究提供了韩国乳腺癌患者甲状腺功能减退症风险的最大人群数据分析之一。接受 RT 治疗的患者的调整风险高于未接受 RT 治疗的乳腺癌患者。这种影响在治疗后立即显现，并持续了大约 9 年。
