skip to main content

Title: Radiation-related thyroid dysfunction: implications for the treatment of Hodgkin's disease

Thyroid-stimulating hormone (TSH) and thyroxine (T/sub 4/) were measured in sera from 214 patients with Hodgkin's disease. The literature was reviewed for patients with lymphoma or head and neck carcinoma who had received prior radiation therapy that encompassed the thyroid. Among 169 patients who had been treated with mantle radiation therapy at our center, 112 (66%) had evidence of thyroid dysfunction, including 43 with depressed T/sub 4/ levels. Among 45 who did not receive mantle irradiation, only three had evidence of dysfunction and none of these had T/sub 4/ depression. Thyroid dysfunction developed slowly, with less than 15% of patients tested during the first year showing dysfunction and the maximum of 66% reached at about 6 years. This entity is very common in lymphoma patients yet often is overlooked except in instances of specific thyroid function evaluation for research. A substantial proportion of patients with head and neck carcinoma develops thyroid dysfunction after irradiation, especially if therapy includes hemithyroidectomy. Serum TSH measurement every 6 months for at least 5 to 6 years after irradiation will detect early thyroid dysfunction. All patients with elevated serum TSH should be treated with sodium levothyroxine, regardless of whether they are clinically hypothyroid.
Authors:
; ; ; ;
Publication Date:
OSTI Identifier:
5275748
Resource Type:
Journal Article
Resource Relation:
Journal Name: Ann. Intern. Med.; (United States); Journal Volume: 92:1
Research Org:
Univ. of Maryland School of Medicine, Baltimore
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; 62 RADIOLOGY AND NUCLEAR MEDICINE; 59 BASIC BIOLOGICAL SCIENCES; HYPOTHYROIDISM; RADIOINDUCTION; RADIOTHERAPY; SIDE EFFECTS; THYROID; DELAYED RADIATION EFFECTS; BLOOD SERUM; CARCINOMAS; COBALT 60; GAMMA RADIATION; HEAD; HODGKINS DISEASE; LOCAL IRRADIATION; LYMPHOMAS; NECK; PATHOLOGY; PATIENTS; SARCOMAS; THERAPY; THYROXINE; TSH; AMINO ACIDS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BIOLOGICAL EFFECTS; BIOLOGICAL RADIATION EFFECTS; BODY; BODY AREAS; CARBOXYLIC ACIDS; COBALT ISOTOPES; DISEASES; ELECTROMAGNETIC RADIATION; ENDOCRINE DISEASES; ENDOCRINE GLANDS; GLANDS; HORMONES; INTERMEDIATE MASS NUCLEI; INTERNAL CONVERSION RADIOISOTOPES; IONIZING RADIATIONS; IRRADIATION; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; MINUTES LIVING RADIOISOTOPES; NEOPLASMS; NUCLEAR MEDICINE; NUCLEI; ODD-ODD NUCLEI; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANIC HALOGEN COMPOUNDS; ORGANIC IODINE COMPOUNDS; ORGANS; PEPTIDE HORMONES; PITUITARY HORMONES; RADIATION EFFECTS; RADIATIONS; RADIOISOTOPES; RADIOLOGY; THYROID HORMONES; YEARS LIVING RADIOISOTOPES 560151* -- Radiation Effects on Animals-- Man; 550603 -- Medicine-- External Radiation in Therapy-- (1980-); 550900 -- Pathology