Hypothyroidism following treatment for head and neck cancer

Journal Article · · Ann. Otol., Rhinol., Laryngol.; (United States)

DOI:https://doi.org/10.1177/000348948109000506· OSTI ID:5391050

Vrabec, D P; Heffron, T J

One hundred ninety-six head and neck patients were studied to determine the effects of radiation therapy and surgery on thyroid function. Serum thyroid-stimulating hormone (TSH) levels were obtained as a screening test for primary hypothyroidism. Elevated TSH levels were found in 57 of the 196 patients (29.1%). The highest incidence of abnormal TSH values (66%) occurred in the group treated with combination radiation therapy and surgery, including partial thyroidectomy. TSH levels rose early in the posttreatment period with 60% of the abnormal values occurring within the first three posttreatment years. Posttreatment thyroid dysfunction was twice as common in women (48.6%) as in men (25.4%). When serum thyroxine levels by radioimmunoassay (T4RIA) were correlated with the elevated serum TSH levels, a similar pattern was seen with 65% of the patients in Group 3 having a decreased T4RIA level indicating overt hypothyroidism. Pretreatment levels of thyroid function including thyroid antibody studies should be established for all patients. Serial TSH levels should be done every three months during the first three posttreatment years and semiannually thereafter as long as the patient will return for follow-up care. All patients treated with combination radiation therapy and surgery who develop elevated TSH levels should be treated with thyroid replacement therapy. Patients receiving radiation therapy alone should receive replacement thyroid therapy if they develop a depressed T4RIA value or a pattern of gradually increasing TSH levels.

• Research Organization: Department of Otolaryngology, Geisinger Medical Center, Danville, PA
• OSTI ID: 5391050
• Journal Information: Ann. Otol., Rhinol., Laryngol.; (United States), Journal Name: Ann. Otol., Rhinol., Laryngol.; (United States) Vol. 90:5 Pt 1; ISSN AORHA
• Country of Publication: United States
• Language: English

Related Subjects

550201 -- Biochemistry-- Tracer Techniques
550603* -- Medicine-- External Radiation in Therapy-- (1980-)
560151 -- Radiation Effects on Animals-- Man
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
AMINO ACIDS
BIOCHEMISTRY
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
CARBOXYLIC ACIDS
CHEMISTRY
DISEASES
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
HEAD
HORMONES
HYPOTHYROIDISM
ISOTOPE APPLICATIONS
MEDICINE
NECK
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC IODINE COMPOUNDS
ORGANS
PATIENTS
PEPTIDE HORMONES
PITUITARY HORMONES
RADIATION EFFECTS
RADIOASSAY
RADIOIMMUNOASSAY
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SURGERY
THERAPY
THYROID
THYROID HORMONES
THYROIDECTOMY
THYROXINE
TRACER TECHNIQUES
TSH