[手术放疗联合治疗ORL区癌后甲状腺功能减退]。

S Auberson, H Kündig
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引用次数: 0

摘要

简介:甲状腺功能减退是头颈癌治疗的一种常见并发症,但甲状腺功能的常规检测通常不做。手术和放疗相结合似乎会增加甲状腺功能减退的风险。方法:对82例头颈癌患者(不同术式切除联合术前或术后放疗)进行甲状腺功能测定。治疗前1 ~ 220个月测量甲状腺素和T4。结果:82例患者中43例(52%)甲状腺检查异常。43例中有20例(24%)需要激素替代。接受全喉切除术或咽喉切除术的患者,不论是否伴有甲状腺切除术,超过85%的患者有甲状腺功能减退,其中超过一半的患者需要替代治疗。对于其他类型的手术,甲状腺功能减退的发生率为32%,10%的患者需要替代。讨论:高百分比的患者接受手术和放疗发展甲状腺功能减退。根据我们的经验,常规甲状腺功能检查是必要的。
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[Hypothyroidism after combined surgical and radiotherapy treatment of cancer of the ORL area].

Introduction: Hypothyroidism is a well described complication of head and neck cancer treatment, but routine testing of thyroid function is generally not done. The combination of surgery and radiotherapy seems to increase the risk of thyroid hypofunction.

Methods: Thyroid function was measured in 82 patients treated for head and neck cancer (different types of surgical resection combined with pre- or postoperative radiotherapy). The treatment was undertaken 1 to 220 months before measurement of THS and T4.

Results: 43 out of the 82 patients (52%) had abnormal thyroid tests. Hormonal replacement was necessary in 20/43 cases (24%). More than 85% of patients treated by total laryngectomy or pharyngo-laryngectomy, associated with hemithyroidectomy or not, had hypothyroidism and replacement therapy was necessary in more than half of these patients. For the other types of surgery the incidence of hypothyroidism was 32% with 10% of patients needing substitution.

Discussion: A high percentage of patients treated by surgery and radiotherapy develop hypothyroidism. In our experience, routine thyroid function testing is necessary in this group.

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