Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial
Abstract Background Hypothyroidism (HT) and subclinical HT after radiotherapy is frequent in nasopharyngeal carcinoma (NPC) patients, results in negative impact on patients' quality of life. The percentage of thyroid volume receiving more than 40 Gy (V40) ≤ 85% was reported to be a useful dose...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-023-02329-x |
| _version_ | 1827633572496801792 |
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| author | Yun Xu Hewei Peng Guangjian Su Yanming Cheng Qiaojuan Guo Lanyan Guo Xian-E Peng Jiangfeng Ke |
| author_facet | Yun Xu Hewei Peng Guangjian Su Yanming Cheng Qiaojuan Guo Lanyan Guo Xian-E Peng Jiangfeng Ke |
| author_sort | Yun Xu |
| collection | DOAJ |
| description | Abstract Background Hypothyroidism (HT) and subclinical HT after radiotherapy is frequent in nasopharyngeal carcinoma (NPC) patients, results in negative impact on patients' quality of life. The percentage of thyroid volume receiving more than 40 Gy (V40) ≤ 85% was reported to be a useful dose constraint to adopt during intensity-modulated radiation therapy (IMRT) planning. This study aims to verify whether V40 ≤ 85% can be used as an effective dose constraint in IMRT planning in a randomized clinical trial. Methods This single-center 1:1 randomized clinical trial was conducted in Fujian province hospital between March 2018 and September 2022. All patients were treated with IMRT and randomized to induction chemo followed by concurrent chemo-IMRT or concurrent chemo-IMRT alone. Ninety-two clinically NPC patients were included in this study. The thyroid function tests were performed for all patients before and after radiation at regular intervals. Thyroid dose-constraint was defined as V40 ≤ 85%. The primary outcome in this study was subclinical HT. Results Median follow up was 34 months. Significant difference in the incidence of subclinical HT between the thyroid dose-constraint group and unrestricted group was observed (P = 0.023). The risk of subclinical HT in the thyroid dose-constraint group was lower than that in the unrestricted group (P = 0.022). Univariate and multivariate cox regression analysis indicated that thyroid dose-constraint was a protective effect of subclinical HT (HR = 0.408, 95% CI 0.184–0.904; HRadjusted = 0.361, 95% CI 0.155–0.841). Conclusion V40 ≤ 85% can be used as an effective dose constraint in IMRT planning to prevent radiation-induced subclinical HT. |
| first_indexed | 2024-03-09T15:01:26Z |
| format | Article |
| id | doaj.art-d9d7862dee114c9281de4c403a5b79d1 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-03-09T15:01:26Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-d9d7862dee114c9281de4c403a5b79d12023-11-26T13:54:02ZengBMCRadiation Oncology1748-717X2023-08-011811710.1186/s13014-023-02329-xThyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trialYun Xu0Hewei Peng1Guangjian Su2Yanming Cheng3Qiaojuan Guo4Lanyan Guo5Xian-E Peng6Jiangfeng Ke7Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical UniversityDepartment of Clinical Laboratory, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalSchool of Medical Imaging, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical UniversityDepartment of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalAbstract Background Hypothyroidism (HT) and subclinical HT after radiotherapy is frequent in nasopharyngeal carcinoma (NPC) patients, results in negative impact on patients' quality of life. The percentage of thyroid volume receiving more than 40 Gy (V40) ≤ 85% was reported to be a useful dose constraint to adopt during intensity-modulated radiation therapy (IMRT) planning. This study aims to verify whether V40 ≤ 85% can be used as an effective dose constraint in IMRT planning in a randomized clinical trial. Methods This single-center 1:1 randomized clinical trial was conducted in Fujian province hospital between March 2018 and September 2022. All patients were treated with IMRT and randomized to induction chemo followed by concurrent chemo-IMRT or concurrent chemo-IMRT alone. Ninety-two clinically NPC patients were included in this study. The thyroid function tests were performed for all patients before and after radiation at regular intervals. Thyroid dose-constraint was defined as V40 ≤ 85%. The primary outcome in this study was subclinical HT. Results Median follow up was 34 months. Significant difference in the incidence of subclinical HT between the thyroid dose-constraint group and unrestricted group was observed (P = 0.023). The risk of subclinical HT in the thyroid dose-constraint group was lower than that in the unrestricted group (P = 0.022). Univariate and multivariate cox regression analysis indicated that thyroid dose-constraint was a protective effect of subclinical HT (HR = 0.408, 95% CI 0.184–0.904; HRadjusted = 0.361, 95% CI 0.155–0.841). Conclusion V40 ≤ 85% can be used as an effective dose constraint in IMRT planning to prevent radiation-induced subclinical HT.https://doi.org/10.1186/s13014-023-02329-xSubclinical hypothyroidismIMRTNasopharyngeal carcinoma |
| spellingShingle | Yun Xu Hewei Peng Guangjian Su Yanming Cheng Qiaojuan Guo Lanyan Guo Xian-E Peng Jiangfeng Ke Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial Radiation Oncology Subclinical hypothyroidism IMRT Nasopharyngeal carcinoma |
| title | Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial |
| title_full | Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial |
| title_fullStr | Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial |
| title_full_unstemmed | Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial |
| title_short | Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial |
| title_sort | thyroid v40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy a randomized clinical trial |
| topic | Subclinical hypothyroidism IMRT Nasopharyngeal carcinoma |
| url | https://doi.org/10.1186/s13014-023-02329-x |
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