Farshchian Negin, Amirifard Nasrin, Azar Mohammad Hosein Saiedian, Heydarheydari Sahel, Farshchian Nazanin, Haghparast Abbas
Department of Radiation Oncology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Clinical Research Development Center, Imam Reza Hospital, Kermanshah, Iran.
Rep Pract Oncol Radiother. 2022 Sep 19;27(4):691-698. doi: 10.5603/RPOR.a2022.0074. eCollection 2022.
Radiation exposure to the thyroid gland seems unavoidable in breast cancer (BC) patients receiving radiation therapy (RT) to the supraclavicular (SC) region. Hence, this study aimed to evaluate the effects of SC region RT on thyroid function and the prevalence of radiation-induced hypothyroidism (RIHT) in BC patients at regular intervals post-treatment.
Twenty-one patients with BC were enrolled in this analytical cross-sectional study by simple and convenient sampling, from March 2019 to March 2020. Thyroid function and the prevalence of RIHT were evaluated and compared by measuring the serum of thyroid-stimulating hormone (TSH) and free thyroxine hormone (fT4) levels before radiation therapy (pre-RT) and 3 and 6 months after radiation therapy (post-RT). The patients underwent 3 dimensional conformal. radiation therapy (3D CRT) of breast/chest wall, axillary, and supraclavicular lymph nodes with 50 Gy/25 fractions/5 weeks. The collected data were analyzed using SPSS software (version 20).
Serum levels of TSH increased at 3 and 6 months post-RT, this increase was not statistically significant (p > 0.05). Nevertheless, serum levels of fT4 were significantly elevated at 3 and 6 months post-RT (p < 0.01). A correlation was observed between the follow-up period and the incidence of RIHT, where it was 0% at 3 months and 9.5% at 6 months post-RT. RIHT was not significantly associated with any factors, including patient's age, type of surgery, thyroid gland dose, and thyroid gland volume.
It seems that SC region RT does not have a significant adverse effect on the thyroid function among BC patients at 3 and 6 months post-treatment. Hence, a long-term follow-up with a larger sample size is suggested.
接受锁骨上（SC）区域放射治疗（RT）的乳腺癌（BC）患者，甲状腺似乎不可避免地会受到辐射暴露。因此，本研究旨在定期评估SC区域放疗对BC患者甲状腺功能的影响以及放射性甲状腺功能减退（RIHT）的患病率。
通过简单便捷的抽样方法，于2019年3月至2020年3月招募了21例BC患者参与本分析性横断面研究。通过测量放疗前（RT前）、放疗后3个月和6个月的血清促甲状腺激素（TSH）和游离甲状腺素激素（fT4）水平，评估并比较甲状腺功能和RIHT的患病率。患者接受了乳腺/胸壁、腋窝和锁骨上淋巴结的三维适形放射治疗（3D CRT），剂量为50 Gy/25次/5周。使用SPSS软件（版本20）对收集的数据进行分析。
放疗后3个月和6个月时，血清TSH水平升高，但这种升高无统计学意义（p>0.05）。然而，放疗后3个月和6个月时，血清fT4水平显著升高（p<0.01）。观察到随访期与RIHT发生率之间存在相关性，放疗后3个月时为0%，6个月时为9.5%。RIHT与任何因素均无显著相关性，包括患者年龄、手术类型、甲状腺剂量和甲状腺体积。
似乎SC区域放疗在治疗后3个月和6个月时对BC患者的甲状腺功能没有显著不良影响。因此，建议进行更大样本量的长期随访。
