Alteracion de la funcion tiroidea en los pacientes que se realizo radioterapia cervical

abstract

Introduction: The aim of this study is to determine whether the incidence of hypothyroidism in patients with Head and Neck Cancer who have undergone neck radiotherapy, justifies the inclusion of monitoring of the thyroid function in the preoperative and follow-up evaluation protocols. Material and M...

ethods: A retrospective study was conducted with all the patients seen in the Oncology Section of the Otorhinolaryngology Department in the Hospital de Clínicas, Montevideo, Uruguay, from January 1970 to May 2008. A total of 550 medical records were analyzed. From the 550 patients, 188 patients were excluded, due to the fact that they had not received radiotherapy as part of the treatment, and 362 were included in the study. 55 patients had a dosage of thyroid-stimulating hormone (TSH) after the treatment with radiotherapy. Hypothyroidism was defined as a TSH value over or equal to 4.5 mUI/L, regardless of whether it presented symptoms or not. Results: 36.4% of the patients were diagnosed clinical or subclinical hypothyroidism. It was determined that the type of treatment carried out, especially whether surgical resection was performed or not, constitutes the most significant predictive factor in the development of hypothyroidism (p 0.054). Conclusion: Monitoring of the thyroid function has to be included in the follow-up and control protocols of every patient who undergoes neck RT, on a six-month or annual basis, at least during the first 5 post-treatment years, and be derived to the endocrinologist for hormone replacement in patients with TSH values over 4.5 mUI/L, whether they present symptoms or not.

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