Prevalence of Hypothyroidism Following Radiotherapy of Nasopharyngeal Cancer Patients in Srinagarind Hospital between 1994 and 2007
Keywords:
Hypothyroidism, Nasopharyngeal cancer, RadiotherapyAbstract
Objectives : To investigate the frequency and severity of hypothyroidism following external beam radiotherapy to head and neck region in the treatment of nasopharyngeal cancer and to evaluate factors related with prevalence of hypothyroidism. Methods and Materials: Patients with non-metastatic nasopharyngeal cancer treated with radiotherapy to head and neck region in Srinagarind hospital between January 1994 and December 2007. These patients were evaluated thyroid function (TSH and FT4) and symptoms of hypothyroidism when they came to be followed up after complete radiotherapy. Then the patient’s data were reviewed regarding to age, gender, image fi ndings, staging, histopathology, radiation fi elds, radiation dose, chemotherapy and clinical status. Results : Eighty fi ve nasopharygeal cancer patients were enrolled to evaluate thyroid function. Ten patients (12%) have developed hypothyroidism, fi ve of them were classifi ed as central hypothyroidism, and fi ve were primary hypothyroidism. Seven patients had subclinical hypothyroidism and three patients had clinical hypothyroidism. The latent period of hypothyroidism ranged between 5 months to 15 years after complete radiotherapy. In clinical hypothyroid patients, clinical presentations were not so obvious. From statistical analyses, only latency of post-radiation time showed signifi cant infl uence to development of primary hypothyroidism and adjuvant chemotherapy influenced the development of central hypothyroidism. Conclusion : The prevalence of hypothyroidism in our study is 12% at 15years after radiotherapy and most of the hypothyroid patients were subclinical hypothyroidism. So, we recommend thyroid function test to be a routine follow-up check for the patients who had been treated by radiotherapy to head and neck region.
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