Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy
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.
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Posted 13 Jan, 2021
On 05 Jan, 2021
Received 27 Dec, 2020
On 26 Dec, 2020
Received 20 Dec, 2020
Invitations sent on 18 Dec, 2020
On 18 Dec, 2020
On 12 Dec, 2020
On 12 Dec, 2020
On 12 Dec, 2020
On 11 Nov, 2020
Received 10 Nov, 2020
Received 05 Nov, 2020
On 03 Sep, 2020
On 31 Aug, 2020
Invitations sent on 25 Aug, 2020
On 17 Aug, 2020
On 16 Aug, 2020
On 16 Aug, 2020
On 14 Aug, 2020
Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy
Posted 13 Jan, 2021
On 05 Jan, 2021
Received 27 Dec, 2020
On 26 Dec, 2020
Received 20 Dec, 2020
Invitations sent on 18 Dec, 2020
On 18 Dec, 2020
On 12 Dec, 2020
On 12 Dec, 2020
On 12 Dec, 2020
On 11 Nov, 2020
Received 10 Nov, 2020
Received 05 Nov, 2020
On 03 Sep, 2020
On 31 Aug, 2020
Invitations sent on 25 Aug, 2020
On 17 Aug, 2020
On 16 Aug, 2020
On 16 Aug, 2020
On 14 Aug, 2020
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