Thyroid dose‐volume thresholds for the risk of radiation‐related hypothyroidism in nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy—A single‐institution study

Autor: Hao Peng, Yuan Zhang, Cheng-Long Huang, Hong Wen Tan, Rui Guo, Ling Long Tang, Yan Ping Mao, Jun Ma, Liang Peng, Ying Sun, Ai Hua Lin
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Cancer Research
medicine.medical_treatment
Thyroid Gland
Kaplan-Meier Estimate
0302 clinical medicine
risk factors
Medicine
Single institution
Child
Original Research
Aged
80 and over
Nasopharyngeal Carcinoma
Incidence (epidemiology)
Thyroid
Radiotherapy Dosage
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Female
Intensity modulated radiotherapy
Thyroid function
Adult
Risk
medicine.medical_specialty
Adolescent
prevalence
Urology
lcsh:RC254-282
Young Adult
03 medical and health sciences
Hypothyroidism
Humans
Radiology
Nuclear Medicine and imaging
In patient
Radiation Injuries
intensity‐modulated radiotherapy
Aged
business.industry
Clinical Cancer Research
Nasopharyngeal Neoplasms
medicine.disease
Radiation therapy
030104 developmental biology
Nasopharyngeal carcinoma
Radiotherapy
Intensity-Modulated
business
Zdroj: Cancer Medicine
Cancer Medicine, Vol 8, Iss 16, Pp 6887-6893 (2019)
ISSN: 2045-7634
DOI: 10.1002/cam4.2574
Popis: Background To identify thyroid dose‐volume thresholds for radiotherapy (RT)‐related hypothyroidism (HT) in patients with nasopharyngeal carcinoma (NPC) treated with intensity‐modulated RT (IMRT). In this way, we desired to guide the design of treatment plans and, finally, lower HT prevalence. Methods In total, 345 NPC patients treated with IMRT were evaluated retrospectively during a median follow‐up of 45.2 (range, 11.3‐64.9) months. Serum‐based assessments of thyroid function before and after IMRT were monitored periodically. Thyroid dose‐volume parameters were analyzed for their association with HT risk. Results In total, 44.1% of patients (152/345) developed primary HT. Analyses of thyroid dose‐volume parameters identified a stringent dose‐volume histogram (DVH) threshold defined by V 25Gy (the percentage thyroid volume that receives >25 Gy, not the absolute volume) ≤60%, V 35Gy ≤ 55%, and V 45Gy ≤ 45%. Patients whose thyroid DVHs satisfied these constraints had a lower prevalence of 2‐year HT compared with the overall prevalence (13.2% vs 25.8%, P 95%, V 35Gy > 90%, and V 45Gy > 75%, and patients whose thyroid DVHs satisfied with these constraints had a higher prevalence of 2‐year HT than the overall incidence (36.0% vs 25.8%, P 95%, V 35Gy > 90%, and V 45Gy > 75% as the “inhibition” DVH line, under the precondition of not compromising the target coverage. These findings could help in the design of individual treatment plans and, eventually, to lowering of HT prevalence.
The risk of radiation‐related hypothyroidism (RHT) varied significantly depending on the dose‐volume parameters of thyroid radiation. We investigated and identified multiple thyroid dose‐volume thresholds for RHT in nasopharyngeal carcinomas treated with intensity‐modulated radiotherapy (RT), to guide risk stratification of RHT and help in the design of individual RT plans.
Databáze: OpenAIRE
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