Department of Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
Cancer Med. 2024 Aug;13(15):e70015. doi: 10.1002/cam4.70015.
Adjuvant chemotherapy is often indicated in patients diagnosed with early breast cancer (EBC). Among others, weight gain is one of the observed side effects of both chemotherapy and other cancer treatments; however, the mechanism is not well-described. In this study, we aimed to assess thyroid function before and shortly after the course of chemotherapy for EBC.
This is a prospective cohort study of women diagnosed with EBC. The main outcome was the thyroid function and body weight before and after completing chemotherapy. Secondary outcomes were the presence of thyroid autoantibodies and treatment radiation dosage. We included 72 patients treated with adjuvant chemotherapy, whereas 59 patients also received supraclavicular locoregional radiotherapy. Triple-negative breast cancer (BC) patients receiving chemoimmunotherapy were excluded.
After the chemotherapy, we observed an increase in thyroid-stimulating hormone (p = 0.03) and a decrease in free-thyroxine (p = 0.0006), with no significant weight change. The prevalence of autoimmune thyroiditis was low. On average 3 months post-chemo, we found no statistically significant difference in the thyroid function of women treated versus not treated with supraclavicular locoregional radiotherapy.
Although statistically significant changes in thyroid hormones were observed, this study suggests no obvious clinically significant changes in thyroid function in women with early BC after the course of chemotherapy. The decrease in thyroid function was not related to autoimmunity, non-thyroidal illness, radiotherapy, or high-dose corticosteroids. Further studies with a longer follow-up of thyroid function after adjuvant chemotherapy and supraclavicular locoregional radiotherapy are needed.
辅助化疗常用于诊断为早期乳腺癌（EBC）的患者。在其他方面，体重增加是化疗和其他癌症治疗观察到的副作用之一；然而，其机制尚未得到很好的描述。在本研究中，我们旨在评估 EBC 患者化疗前后的甲状腺功能。
这是一项前瞻性队列研究，纳入了诊断为 EBC 的女性。主要结局是化疗前后甲状腺功能和体重。次要结局是甲状腺自身抗体和治疗辐射剂量。我们纳入了 72 例接受辅助化疗的患者，其中 59 例还接受了锁骨上区域局部放疗。排除接受化疗免疫治疗的三阴性乳腺癌（BC）患者。
化疗后，我们观察到促甲状腺激素（TSH）增加（p=0.03），游离甲状腺素（FT4）降低（p=0.0006），体重无明显变化。自身免疫性甲状腺炎的患病率较低。化疗后平均 3 个月，我们发现接受与未接受锁骨上区域局部放疗的女性甲状腺功能无统计学差异。
尽管观察到甲状腺激素的统计学显著变化，但本研究表明，EBC 女性在化疗后甲状腺功能没有明显的临床显著变化。甲状腺功能下降与自身免疫、非甲状腺疾病、放疗或大剂量皮质类固醇无关。需要进一步研究辅助化疗和锁骨上区域局部放疗后更长时间的甲状腺功能。
