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Title: Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism

Abstract

Purpose: The incidence of hypothyroidism after radiation therapy for head and neck cancer (HNC) has been found to be ≤53%. Medical treatment of hypothyroidism can be costly and difficult to titrate. The aim of the present study was to assess the feasibility of free thyroid transfer as a strategy for the prevention of radiation-induced damage to the thyroid gland during radiation therapy for HNC. Methods and Materials: A prospective feasibility study was performed involving 10 patients with a new diagnosis of advanced HNC undergoing ablative surgery, radial forearm free-tissue transfer reconstruction, and postoperative adjuvant radiation therapy. During the neck dissection, hemithyroid dissection was completed with preservation of the thyroid arterial and venous supply for implantation into the donor forearm site. All patients underwent a diagnostic thyroid technetium scan 6 weeks and 12 months postoperatively to examine the functional integrity of the transferred thyroid tissue. Results: Free thyroid transfer was executed in 9 of the 10 recruited patients with advanced HNC. The postoperative technetium scans demonstrated strong uptake of technetium at the forearm donor site at 6 weeks and 12 months for all 9 of the transplanted patients. Conclusions: The thyroid gland can be transferred as a microvascular free transfer with maintenance of function. Thismore » technique could represent a novel strategy for maintenance of thyroid function after head and neck irradiation.« less

Authors:
 [1];  [1];  [2];  [1];  [3];  [4];  [1];  [5];  [1]
  1. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta (Canada)
  2. (Saudi Arabia)
  3. Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta (Canada)
  4. Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta (Canada)
  5. Institute for Head and Neck and Thyroid Cancers, Icahn School of Medicine, Mount Sinai Hospital, New York, New York (United States)
Publication Date:
OSTI Identifier:
22648778
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 1; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FEASIBILITY STUDIES; HYPOTHYROIDISM; NECK; PATIENTS; RADIOTHERAPY; TECHNETIUM; THYROID

Citation Formats

Harris, Jeffrey, Almarzouki, Hani, Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Barber, Brittany, E-mail: brittanybarber0@gmail.com, Scrimger, Rufus, Romney, Jacques, O'Connell, Daniel, Urken, Mark, and Seikaly, Hadi. Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.04.004.
Harris, Jeffrey, Almarzouki, Hani, Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Barber, Brittany, E-mail: brittanybarber0@gmail.com, Scrimger, Rufus, Romney, Jacques, O'Connell, Daniel, Urken, Mark, & Seikaly, Hadi. Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism. United States. doi:10.1016/J.IJROBP.2016.04.004.
Harris, Jeffrey, Almarzouki, Hani, Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Barber, Brittany, E-mail: brittanybarber0@gmail.com, Scrimger, Rufus, Romney, Jacques, O'Connell, Daniel, Urken, Mark, and Seikaly, Hadi. Thu . "Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism". United States. doi:10.1016/J.IJROBP.2016.04.004.
@article{osti_22648778,
title = {Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism},
author = {Harris, Jeffrey and Almarzouki, Hani and Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah and Barber, Brittany, E-mail: brittanybarber0@gmail.com and Scrimger, Rufus and Romney, Jacques and O'Connell, Daniel and Urken, Mark and Seikaly, Hadi},
abstractNote = {Purpose: The incidence of hypothyroidism after radiation therapy for head and neck cancer (HNC) has been found to be ≤53%. Medical treatment of hypothyroidism can be costly and difficult to titrate. The aim of the present study was to assess the feasibility of free thyroid transfer as a strategy for the prevention of radiation-induced damage to the thyroid gland during radiation therapy for HNC. Methods and Materials: A prospective feasibility study was performed involving 10 patients with a new diagnosis of advanced HNC undergoing ablative surgery, radial forearm free-tissue transfer reconstruction, and postoperative adjuvant radiation therapy. During the neck dissection, hemithyroid dissection was completed with preservation of the thyroid arterial and venous supply for implantation into the donor forearm site. All patients underwent a diagnostic thyroid technetium scan 6 weeks and 12 months postoperatively to examine the functional integrity of the transferred thyroid tissue. Results: Free thyroid transfer was executed in 9 of the 10 recruited patients with advanced HNC. The postoperative technetium scans demonstrated strong uptake of technetium at the forearm donor site at 6 weeks and 12 months for all 9 of the transplanted patients. Conclusions: The thyroid gland can be transferred as a microvascular free transfer with maintenance of function. This technique could represent a novel strategy for maintenance of thyroid function after head and neck irradiation.},
doi = {10.1016/J.IJROBP.2016.04.004},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 96,
place = {United States},
year = {Thu Sep 01 00:00:00 EDT 2016},
month = {Thu Sep 01 00:00:00 EDT 2016}
}