Rahimi Niloofar, Feizi Iraj, Mashayekhi Farzaneh, Salehi Oveis, Norouzi Faezeh, Iranparvar-Alamdari Manochehr, Kani Amir Abbas, Zandian Hamed, Khalaji Amirreza
Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Department of Thoracic Surgery, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
Can Oncol Nurs J. 2024 Nov 1;34(4):477-489. doi: 10.5737/23688076344477. eCollection 2024 Fall.
The current advances in radiotherapy (RT) have improved the outcome of breast cancer (BC) patients. Despite its therapeutic benefits, the iatrogenic toxicities of RT and its impact on BC survivors are still debated, and further evaluations should be considered. This study aims to assess the rate of subclinical hypothyroidism and hypoparathyroidism among BC patients who were exposed to therapeutic radiation.
Seventy females undergoing RT for BC were enrolled in this cross-sectional study. Laboratory assessment of thyroid stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels was obtained to evaluate thyroid function. The parathyroid function was evaluated by measuring serum levels of Calcium (Ca), Phosphorus (P), and parathyroid hormone (PTH) at baseline, six and 12 months after RT.
The mean age of patients was 54.3±6.4 years. We found no cases of hypothyroidism before radiotherapy. However, nine patients developed hypothyroidism in the six months after radiotherapy (one clinical and eight subclinical, 13% in total), and six patients were identified with hypothyroidism in the 12 months after radiotherapy (one clinical and five subclinical, 8.7% in total). Significant relationships were observed in the hypothyroidism rate at both six months (p = 0.003) and 12 months (p = 0.028) after RT compared with the baseline. There was no case of hypoparathyroidism before and after RT.
In summary, we found that thyroid and parathyroid dysfunction after RT are relatively common findings among women with BC. It is a treatable source of morbidity in patients undergoing RT. Therefore, routine thyroid function monitoring should be recommended to improve the quality of life in BC survivors.
放射治疗（RT）的当前进展改善了乳腺癌（BC）患者的治疗结果。尽管其具有治疗益处，但RT的医源性毒性及其对BC幸存者的影响仍存在争议，应考虑进一步评估。本研究旨在评估接受治疗性辐射的BC患者中亚临床甲状腺功能减退和甲状旁腺功能减退的发生率。
70名接受BC放疗的女性纳入了这项横断面研究。通过实验室评估促甲状腺激素（TSH）、游离甲状腺素（fT4）和游离三碘甲状腺原氨酸（fT3）水平来评估甲状腺功能。在基线、放疗后6个月和12个月时，通过测量血清钙（Ca）、磷（P）和甲状旁腺激素（PTH）水平来评估甲状旁腺功能。
患者的平均年龄为54.3±6.4岁。我们发现放疗前没有甲状腺功能减退的病例。然而，9名患者在放疗后6个月出现甲状腺功能减退（1例临床型和8例亚临床型，总计13%），6名患者在放疗后12个月被诊断为甲状腺功能减退（1例临床型和5例亚临床型，总计8.7%）。与基线相比，放疗后6个月（p = 0.003）和12个月（p = 0.028）的甲状腺功能减退发生率均存在显著相关性。放疗前后均无甲状旁腺功能减退的病例。
总之，我们发现放疗后甲状腺和甲状旁腺功能障碍在BC女性患者中是相对常见的情况。这是接受放疗患者中一种可治疗的发病原因。因此，建议进行常规甲状腺功能监测以提高BC幸存者的生活质量。
