Опухоли головы и шеи. 2025; 15: 92-98
Постлучевые изменения функции щитовидной железы при лечении опухолей головы и шеи: современное состояние проблемы
https://doi.org/10.17650/2222-1468-2025-15-2-92-98Аннотация
Постлучевой гипотиреоз является распространенным осложнением лечения опухолей опухолями головы и шеи: частота его развития составляет 6–50 %. Даже субклинический гипотиреоз ассоциирован с такими заболеваниями сердечно-сосудистой системы, как ишемическая болезнь сердца и инфаркт миокарда. Данная патология может значимо влиять не только на качество, но и на продолжительность жизни пациентов, перенесших лучевую терапию.
В статье представлены результаты исследований, посвященных определению предикторов постлучевого гипотиреоза, а также клинические случаи, демонстрирующие результаты лучевой терапии при раке головы и шеи.
Список литературы
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2. Lee V., Chan S.Y., Choi C.W. et al. Dosimetric predictors of hypothyroidism after radical intensity-modulated radiation therapy for non-metastatic nasopharyngeal carcinoma. Clin Oncol 2016;28(8):52–60. DOI: 10.1016/j.clon.2016.05.004
3. McDowell L.J., Rock K., Xu W. et al. Long-term late toxicity, quality of life, and emotional distress in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 2018;102(2):340–52. DOI: 10.1016/j.ijrobp.2018.05.060
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6. Biondi B., Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrin 2004;24(1):1–13. DOI: 10.1385/ENDO:24:1:001
7. Gencer B., Collet T.H., Virgini V. et al. Thyroid Studies Collaboration. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation 2012;126(9):1040–9. DOI: 10.1161/CIRCULATIONAHA.112.096024
8. Horodynska O.Yu. Syndrome of hypothyroidism as a factor of cardiovascular pathology development (literature review). 2017;13(7):503–5.
9. Tariq K., Rana F., Zaiden R. et al. Radiation induced hypothyroidism and its relationship with gender and smoking history in head and neck cancer patients. J Nucl Med Radiat Ther 2014;5(3):113–7. DOI: 10.14740/wjon835w
10. Lertbutsayanukul C., Kitpanit S., Prayongrat A. et al. Validation of previously reported predictors for radiation-induced hypothyroidism in nasopharyngeal cancer patients treated with intensity-modulated radiation therapy, a post hoc analysis from a phase III randomized trial. J Radiat Res 2018;59(4):446–55. DOI: 10.1093/jrr/rry036
11. Zhou L., Chen J., Shen W. et al. Thyroid V 50 is a risk factor for hypothyroidism in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: a retrospective study. Radiat Oncol 2020;15(1):68. DOI: 10.1186/s13014-020-01490-x
12. Fujiwara M., Kamikonya N., Odawara S. et al. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases. J Radiat Res 2015;56(3):577–82. DOI: 10.1093/jrr/rrv006
13. Zhai R.-P., Kong F.-F., Du C.-R. et al. Radiation-induced hypothyroidism after IMRT for nasopharyngeal carcinoma: clinical and dosimetric predictors in a prospective cohort study. Oral Oncol 2017;68:44–9. DOI: 10.1016/j.oraloncology.2017.03.005
14. Murthy V., Narang K., Ghosh-Laskar S. et al. Hypothyroidism after 3-dimensional conformal radiotherapy and intensitymodulated radiotherapy for head and neck cancers: prospective data from 2 randomized controlled trials. Head Neck 2014;36(11):1573–80. DOI: 10.1002/hed.23482
15. Ling S., Bhatt A.D., Brown N.V. et al. Correlative study of dose to thyroid and incidence of subsequent dysfunction after head and neck radiation. Head Neck 2017;39(3):548–54. DOI: 10.1002/hed.24643
16. Chow J.C.H., Cheung K.M., Cheung G.T.C. et al. Dose-volume predictors of post-radiation primary hypothyroidism in head and neck cancer: a systematic review. Clin Transl Radiat Oncol 2022;33:83–92. DOI: 10.1016/j.ctro.2022.01.001
17. Bakhshandeh M., Hashemi B., Mahdavi S.R. et al. Normal tissue complication probability modeling of radiation-induced hypothyroidism after head-and-neck radiation therapy. Int J Radiat Oncol Biol Phys 2013;85(2):514–21. DOI: 10.1016/j.ijrobp.2012.03.034
18. Denaro N., Merlano M.C., Russi E.G. Follow-up in head and neck cancer: do more does it mean do better? A systematic review and our proposal based on our experience. Clin Exp Otorhinolaryngol 2016;9(4):287–97. DOI: 10.21053/ceo.2015.00976
19. Forastiere A.A., Zhang Q., Weber R.S. et al. Long-term results of RTOG 91–11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 2013;31(7):84552. DOI: 10.1200/JCO.2012.43.6097
Head and Neck Tumors (HNT). 2025; 15: 92-98
Post-radiation changes in thyroid function during treatment of head and neck tumors: current state of the problem
https://doi.org/10.17650/2222-1468-2025-15-2-92-98Abstract
Post-radiation hypothyroidism is a common complication of treatment of head and neck tumors: its incidence is 6–50 %. Even subclinical hypothyroidism is associated with such cardiovascular diseases as ischemic heart disease and myocardial infarction. This pathology can significantly affect both quality of life and lifespan of patients who underwent radiation therapy.
The article presents results of studies on identification of predictors of post-radiation hypothyroidism, as well as clinical cases demonstrating results of radiation therapy in head and neck cancer treatment.
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2. Lee V., Chan S.Y., Choi C.W. et al. Dosimetric predictors of hypothyroidism after radical intensity-modulated radiation therapy for non-metastatic nasopharyngeal carcinoma. Clin Oncol 2016;28(8):52–60. DOI: 10.1016/j.clon.2016.05.004
3. McDowell L.J., Rock K., Xu W. et al. Long-term late toxicity, quality of life, and emotional distress in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 2018;102(2):340–52. DOI: 10.1016/j.ijrobp.2018.05.060
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6. Biondi B., Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrin 2004;24(1):1–13. DOI: 10.1385/ENDO:24:1:001
7. Gencer B., Collet T.H., Virgini V. et al. Thyroid Studies Collaboration. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation 2012;126(9):1040–9. DOI: 10.1161/CIRCULATIONAHA.112.096024
8. Horodynska O.Yu. Syndrome of hypothyroidism as a factor of cardiovascular pathology development (literature review). 2017;13(7):503–5.
9. Tariq K., Rana F., Zaiden R. et al. Radiation induced hypothyroidism and its relationship with gender and smoking history in head and neck cancer patients. J Nucl Med Radiat Ther 2014;5(3):113–7. DOI: 10.14740/wjon835w
10. Lertbutsayanukul C., Kitpanit S., Prayongrat A. et al. Validation of previously reported predictors for radiation-induced hypothyroidism in nasopharyngeal cancer patients treated with intensity-modulated radiation therapy, a post hoc analysis from a phase III randomized trial. J Radiat Res 2018;59(4):446–55. DOI: 10.1093/jrr/rry036
11. Zhou L., Chen J., Shen W. et al. Thyroid V 50 is a risk factor for hypothyroidism in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: a retrospective study. Radiat Oncol 2020;15(1):68. DOI: 10.1186/s13014-020-01490-x
12. Fujiwara M., Kamikonya N., Odawara S. et al. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases. J Radiat Res 2015;56(3):577–82. DOI: 10.1093/jrr/rrv006
13. Zhai R.-P., Kong F.-F., Du C.-R. et al. Radiation-induced hypothyroidism after IMRT for nasopharyngeal carcinoma: clinical and dosimetric predictors in a prospective cohort study. Oral Oncol 2017;68:44–9. DOI: 10.1016/j.oraloncology.2017.03.005
14. Murthy V., Narang K., Ghosh-Laskar S. et al. Hypothyroidism after 3-dimensional conformal radiotherapy and intensitymodulated radiotherapy for head and neck cancers: prospective data from 2 randomized controlled trials. Head Neck 2014;36(11):1573–80. DOI: 10.1002/hed.23482
15. Ling S., Bhatt A.D., Brown N.V. et al. Correlative study of dose to thyroid and incidence of subsequent dysfunction after head and neck radiation. Head Neck 2017;39(3):548–54. DOI: 10.1002/hed.24643
16. Chow J.C.H., Cheung K.M., Cheung G.T.C. et al. Dose-volume predictors of post-radiation primary hypothyroidism in head and neck cancer: a systematic review. Clin Transl Radiat Oncol 2022;33:83–92. DOI: 10.1016/j.ctro.2022.01.001
17. Bakhshandeh M., Hashemi B., Mahdavi S.R. et al. Normal tissue complication probability modeling of radiation-induced hypothyroidism after head-and-neck radiation therapy. Int J Radiat Oncol Biol Phys 2013;85(2):514–21. DOI: 10.1016/j.ijrobp.2012.03.034
18. Denaro N., Merlano M.C., Russi E.G. Follow-up in head and neck cancer: do more does it mean do better? A systematic review and our proposal based on our experience. Clin Exp Otorhinolaryngol 2016;9(4):287–97. DOI: 10.21053/ceo.2015.00976
19. Forastiere A.A., Zhang Q., Weber R.S. et al. Long-term results of RTOG 91–11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 2013;31(7):84552. DOI: 10.1200/JCO.2012.43.6097
