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• W2000968177 abstract "Purpose/Objective(s)Thyroid disorders are one of the radiation-induced late adverse effects. Some authors have reported the predictor of hypothyroidism after radiation therapy for head and neck cancers, but the risk factors were unclear. The purpose of this report is to determine the factors for developing thyroid disorders in the dose volume histogram (DVH) analysis.Materials/MethodsA retrospective evaluation of data from total of 75 consecutive patients undergoing 3D conformal radiation therapy (median dose 66Gy) for head and neck cancers was performed. Radiation therapy was performed between April in 2007 and December in 2009. The median age was 67 years old (range, 20-83 years). 69 male and 6 female were included. 48 patients received concurrent or sequential chemotherapy. Median follow up term was 22 months (range, 1-44 months). Thyroid function was evaluated by the measurement of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels. For the thyroid grand, the mean thyroid dose, and the volume of thyroid gland spared from doses ≥10, 20, 30, and 40Gy (VS10, VS20, VS30, and VS40) were calculated in all patients. The thyroid dose and volume were calculated by treatment planning system, Xio(CMS). We defined hypothyroidism as a serum TSH value greater than our institutional upper limit of normal, >5.0 μU/ml. The Kaplan-Meier technique was used to calculate the incidence of hypothyroidism.ResultsThe cumulative incidences of hypothyroidism were 31.7% and 44.1% at one year and two years after the end of radiation therapy. Twelve cases (16%) took thyroid hormone replacement with levothyroxine. In the DVH analysis, patients who received mean thyroid dose less than 30Gy had significantly low incidence of hypothyroidism. Univariate analyses showed that VS10, VS20, VS30, and VS40 were associated with hypothyroidism. In patients that VS10, VS20, VS30, and VS40 were less than 1cc, 1cc, 6cc, and 7cc, the incidence of hypothyroidism was higher than other patients significantly.ConclusionsHypothyroidism was relatively high incident in the late radiation toxicity, and patients may require thyroid function screening after radiation therapy. The mean dose of thyroid gland, <30Gy may predict the risk of developing hypothyroidism after conformal radiation therapy for head and neck cancers, and the volume of thyroid gland spared from doses ≥10, 20, 30, and 40Gy may be useful constraint for treatment planning. Purpose/Objective(s)Thyroid disorders are one of the radiation-induced late adverse effects. Some authors have reported the predictor of hypothyroidism after radiation therapy for head and neck cancers, but the risk factors were unclear. The purpose of this report is to determine the factors for developing thyroid disorders in the dose volume histogram (DVH) analysis. Thyroid disorders are one of the radiation-induced late adverse effects. Some authors have reported the predictor of hypothyroidism after radiation therapy for head and neck cancers, but the risk factors were unclear. The purpose of this report is to determine the factors for developing thyroid disorders in the dose volume histogram (DVH) analysis. Materials/MethodsA retrospective evaluation of data from total of 75 consecutive patients undergoing 3D conformal radiation therapy (median dose 66Gy) for head and neck cancers was performed. Radiation therapy was performed between April in 2007 and December in 2009. The median age was 67 years old (range, 20-83 years). 69 male and 6 female were included. 48 patients received concurrent or sequential chemotherapy. Median follow up term was 22 months (range, 1-44 months). Thyroid function was evaluated by the measurement of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels. For the thyroid grand, the mean thyroid dose, and the volume of thyroid gland spared from doses ≥10, 20, 30, and 40Gy (VS10, VS20, VS30, and VS40) were calculated in all patients. The thyroid dose and volume were calculated by treatment planning system, Xio(CMS). We defined hypothyroidism as a serum TSH value greater than our institutional upper limit of normal, >5.0 μU/ml. The Kaplan-Meier technique was used to calculate the incidence of hypothyroidism. A retrospective evaluation of data from total of 75 consecutive patients undergoing 3D conformal radiation therapy (median dose 66Gy) for head and neck cancers was performed. Radiation therapy was performed between April in 2007 and December in 2009. The median age was 67 years old (range, 20-83 years). 69 male and 6 female were included. 48 patients received concurrent or sequential chemotherapy. Median follow up term was 22 months (range, 1-44 months). Thyroid function was evaluated by the measurement of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels. For the thyroid grand, the mean thyroid dose, and the volume of thyroid gland spared from doses ≥10, 20, 30, and 40Gy (VS10, VS20, VS30, and VS40) were calculated in all patients. The thyroid dose and volume were calculated by treatment planning system, Xio(CMS). We defined hypothyroidism as a serum TSH value greater than our institutional upper limit of normal, >5.0 μU/ml. The Kaplan-Meier technique was used to calculate the incidence of hypothyroidism. ResultsThe cumulative incidences of hypothyroidism were 31.7% and 44.1% at one year and two years after the end of radiation therapy. Twelve cases (16%) took thyroid hormone replacement with levothyroxine. In the DVH analysis, patients who received mean thyroid dose less than 30Gy had significantly low incidence of hypothyroidism. Univariate analyses showed that VS10, VS20, VS30, and VS40 were associated with hypothyroidism. In patients that VS10, VS20, VS30, and VS40 were less than 1cc, 1cc, 6cc, and 7cc, the incidence of hypothyroidism was higher than other patients significantly. The cumulative incidences of hypothyroidism were 31.7% and 44.1% at one year and two years after the end of radiation therapy. Twelve cases (16%) took thyroid hormone replacement with levothyroxine. In the DVH analysis, patients who received mean thyroid dose less than 30Gy had significantly low incidence of hypothyroidism. Univariate analyses showed that VS10, VS20, VS30, and VS40 were associated with hypothyroidism. In patients that VS10, VS20, VS30, and VS40 were less than 1cc, 1cc, 6cc, and 7cc, the incidence of hypothyroidism was higher than other patients significantly. ConclusionsHypothyroidism was relatively high incident in the late radiation toxicity, and patients may require thyroid function screening after radiation therapy. The mean dose of thyroid gland, <30Gy may predict the risk of developing hypothyroidism after conformal radiation therapy for head and neck cancers, and the volume of thyroid gland spared from doses ≥10, 20, 30, and 40Gy may be useful constraint for treatment planning. Hypothyroidism was relatively high incident in the late radiation toxicity, and patients may require thyroid function screening after radiation therapy. The mean dose of thyroid gland, <30Gy may predict the risk of developing hypothyroidism after conformal radiation therapy for head and neck cancers, and the volume of thyroid gland spared from doses ≥10, 20, 30, and 40Gy may be useful constraint for treatment planning." @default.
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• W2000968177 title "Hypothyroidism After Radiation Therapy for Head-and-Neck Cancer: The Retrospective DVH Analysis of 75 Patients -- Volume of Thyroid Gland Spared From Doses Can Be a New Dose Constraint for Treatment Planning?" @default.
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