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Research article
Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy
Yeu-Jhy Chang
Chang Gung Memorial Hospital, 7Chang Gung Medical Education Research Centre
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6122-4735
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear.
Methods: Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to >50% stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group.
Results: 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement.
Conclusion: Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.
Keywords
Carotid artery stenosis, Head and neck cancer, Hypothyroidism, Ischemic stroke, Radiation therapy
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CURRENT STATUS: Under Review
Version 3
Posted 13 Jan, 2021
No community comments so far
Submission checks complete
On 05 Jan, 2021
No comments provided
Review #2 received
Received 27 Dec, 2020
Reviewer #2 agreed
On 26 Dec, 2020
Review #1 received
Received 20 Dec, 2020
Reviewers invited
Invitations sent on 18 Dec, 2020
Reviewer #1 agreed
On 18 Dec, 2020
Editor assigned
On 12 Dec, 2020
Submission checks complete
On 12 Dec, 2020
Editor invited
On 12 Dec, 2020
No comments provided
Editorial decision: Major revision
On 11 Nov, 2020
Review #2 received
Received 10 Nov, 2020
Review #1 received
Received 05 Nov, 2020
Reviewer #2 agreed
On 03 Sep, 2020
Reviewer #1 agreed
On 31 Aug, 2020
Reviewers invited
Invitations sent on 25 Aug, 2020
Editor assigned
On 17 Aug, 2020
Submission checks complete
On 16 Aug, 2020
Editor invited
On 16 Aug, 2020
First submitted
On 14 Aug, 2020
Metrics
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PDF Downloads: ...
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This preprint is under consideration at BMC Neurology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy
Yeu-Jhy Chang
Chang Gung Memorial Hospital, 7Chang Gung Medical Education Research Centre
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6122-4735
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 13 Jan, 2021
No community comments so far
Submission checks complete
On 05 Jan, 2021
No comments provided
Review #2 received
Received 27 Dec, 2020
Reviewer #2 agreed
On 26 Dec, 2020
Review #1 received
Received 20 Dec, 2020
Reviewers invited
Invitations sent on 18 Dec, 2020
Reviewer #1 agreed
On 18 Dec, 2020
Editor assigned
On 12 Dec, 2020
Submission checks complete
On 12 Dec, 2020
Editor invited
On 12 Dec, 2020
No comments provided
Editorial decision: Major revision
On 11 Nov, 2020
Review #2 received
Received 10 Nov, 2020
Review #1 received
Received 05 Nov, 2020
Reviewer #2 agreed
On 03 Sep, 2020
Reviewer #1 agreed
On 31 Aug, 2020
Reviewers invited
Invitations sent on 25 Aug, 2020
Editor assigned
On 17 Aug, 2020
Submission checks complete
On 16 Aug, 2020
Editor invited
On 16 Aug, 2020
First submitted
On 14 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear.
Methods: Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to >50% stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group.
Results: 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement.
Conclusion: Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.
Figure 1
Figure 2
Figure 3