Karimijavid Mohammad R, Pashaki Abdolazim S, Borzouei Shiva, Khanlarzadeh Elham, Gholami Mohammad H, Nikzad Safoora
Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Radiooncology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Adv Biomed Res. 2023 Feb 25;12:44. doi: 10.4103/abr.abr_218_21. eCollection 2023.
This study aims to evaluate the risk of hypothyroidism (HT) after radiotherapy (RT) of breast and supraclavicular in patients with breast cancer (BC).
In a historical cohort study, the records of all patients with BC who had been referred to the Mahdieh radiotherapy Center of Hamadan from 2017 to 2019 were reviewed. Demographic characteristics, clinical information, previous and current used treatment methods (surgery, radiotherapy, chemotherapy), number of RT sessions and doses, and HT (TSH >5 mIU/L) were extracted from the patient's documents. Data were analyzed using SPSS software version 16.
Out of 304 patients referred to the Center, 266 patients were investigated. The mean TSH was 6.3 ± 7.9 ml/L (1.5 to 65.4). Approximately half of the patients were in Stage 2 of the disease. 37 (16.4%) patients were diagnosed with HT, of which 8.8% were clinical, and 7.5% were subclinical. The mean total dose of HT patients (5621.62 ± 491.67) was significantly higher than other patients (5304.76 ± 937.98). 21 patients (56.8%) in Stage 3 and 4 and 16 (43.2%) patients in Stages 1 and 2 had HT ( = 0.006). Spearman correlation coefficient showed that there was a significant relationship between total dose and TSH hormone (r = 0.624), the number of RT sessions with TSH hormone (r = 0.237), and total dose with T4 hormone (r = -0.232).
The findings of this study showed that the risk of HT increases significantly in patients with BC who undergo RT of breast and supraclavicular. Patients with higher stage, more radiation, and more RT sessions are at higher risk of HT.
本研究旨在评估乳腺癌（BC）患者接受乳腺及锁骨上区放疗（RT）后发生甲状腺功能减退（HT）的风险。
在一项历史性队列研究中，回顾了2017年至2019年转诊至哈马丹马赫迪耶放疗中心的所有BC患者的记录。从患者病历中提取人口统计学特征、临床信息、既往和当前使用的治疗方法（手术、放疗、化疗）、放疗疗程数和剂量以及HT（促甲状腺激素>5 mIU/L）情况。使用SPSS 16.0软件进行数据分析。
在转诊至该中心的304例患者中，对266例患者进行了调查。促甲状腺激素平均水平为6.3±7.9 ml/L（1.5至65.4）。约一半患者处于疾病2期。37例（16.4%）患者被诊断为HT，其中临床HT占8.8%，亚临床HT占7.5%。HT患者的平均总剂量（5621.62±491.67）显著高于其他患者（5304.76±937.98）。3期和4期患者中有21例（56.8%）发生HT，1期和2期患者中有16例（43.2%）发生HT（P = 0.006）。Spearman相关系数显示，总剂量与促甲状腺激素水平之间存在显著相关性（r = 0.624），放疗疗程数与促甲状腺激素水平之间存在显著相关性（r = 0.237），总剂量与甲状腺素水平之间存在显著相关性（r = -0.232）。
本研究结果表明，接受乳腺及锁骨上区放疗的BC患者发生HT的风险显著增加。疾病分期较高、放疗剂量较大以及放疗疗程数较多的患者发生HT的风险更高。
