AI Article Synopsis

  • Hypothyroidism is a common late side effect following radiotherapy for head and neck cancer, which the JCOG1008 trial aimed to investigate by analyzing patient data.
  • The trial enrolled 261 patients from 28 institutions between 2012 and 2018 and conducted thyroid function tests to identify factors associated with developing hypothyroidism post-treatment.
  • Results showed that 16.7% of patients developed hypothyroidism within 2 years, with significant factors being the use of weekly cisplatin and lower baseline free thyroxine levels in those undergoing intensity-modulated radiotherapy.

Article Abstract

Background And Purpose: Hypothyroidism is a recognized late adverse event following radiotherapy for head and neck cancer (HNC). In the JCOG1008 trial, we treated patients with high-risk HNC with postoperative chemoradiotherapy. We aimed to elucidate factors associated with hypothyroidism by analyzing the JCOG1008 data.

Materials And Methods: In 2012-2018, 261 patients from 28 institutions were enrolled in JCOG1008. Thyroid function tests were conducted to assess hypothyroidism, including free thyroxine (FT4) and thyroid-stimulating hormone assays. Hypothyroidism was defined as Grade 2 or higher in CTCAE v4.0. Various clinical and dosimetric parameters were analyzed. In radiotherapy, there were no dose constraints for the thyroid. Multivariable analysis was conducted on these variables to identify predictive factors for hypothyroidism.

Results: The analysis included 162 patients (57 with 3D-CRT and 105 with IMRT), with a median follow-up of 4.7 years (0.3-9.3 years). Among these, 27 (16.7 %) developed hypothyroidism within 2 years after radiotherapy. In a multivariable analysis, the weekly cisplatin [OR=7.700 (CI: 1.632-36.343, p = 0.010)] and baseline FT4 [OR=0.009 (CI: <0.001-0.313, p = 0.010)] were significantly associated with hypothyroidism in the IMRT group. Regarding dosimetric characteristics, V [OR=1.069 (CI: 0.999-1.143, p = 0.054)] was potentially associated with the development of hypothyroidism.

Conclusion: The study revealed that the incidence of hypothyroidism within 2 years after postoperative chemoradiotherapy for high-risk HNC was 16.7 % based on analytical results from prospective clinical trials.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oraloncology.2024.106976DOI Listing

Publication Analysis

Top Keywords

factors associated
8
postoperative chemoradiotherapy
8
head neck
8
neck cancer
8
patients high-risk
8
multivariable analysis
8
hypothyroidism
6
incidence risk
4
risk factors
4
associated development
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!