Abstract
Background. In patients with head and neck cancer, radiation treatment (RT) is a risk factor for hypothyroidism. However, the specific magnitude of risk after RT in older patients is not known. Methods. We identified 5916 patients (age > 65 years) from SEER-Medicare diagnosed with head and neck cancer from 1992 to 2002. Proportional hazards models compared hypothyroidism risk after any RT versus surgery alone. Results. In patients treated with RT, 5-year incidence of hypothyroidism was 20% and 10-year incidence was 59%; in patients treated with surgery alone, incidence was 7% and 39% (p < .001). Patients treated with RT had increased adjusted risk (hazard ratio [HR] = 2.14; 95% confidence interval [CI] = 1.74-2.62), persisting for up to 10 years of follow-up (HR = 1.85, 95% CI = 1.39-2.44 from 5 to 10 years). Conclusion. In older patients with head and neck cancer, RT is associated with elevated hypothyroidism risk. As onset may be delayed for years, patients may require lifelong thyroid function screening after treatment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1031-1038 |
| Number of pages | 8 |
| Journal | Head and Neck |
| Volume | 31 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2009 |
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Keywords
- Head and neck cancer
- Hypothyroidism
- Radiation
- Survivorship
- Toxicity
ASJC Scopus subject areas
- Otorhinolaryngology
Cite this
Hypothyroidism in older patients with head and neck cancer after treatment with radiation : A population-based study. / Smith, Grace L.; Smith, Benjamin D.; Garden, Adam S.; Rosenthal, David I.; Sherman, Steven I.; Morrison, William H.; Schwartz, David L.; Weber, Randal S.; Buchholz, Thomas A.
In: Head and Neck, Vol. 31, No. 8, 08.2009, p. 1031-1038.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hypothyroidism in older patients with head and neck cancer after treatment with radiation
T2 - A population-based study
AU - Smith, Grace L.
AU - Smith, Benjamin D.
AU - Garden, Adam S.
AU - Rosenthal, David I.
AU - Sherman, Steven I.
AU - Morrison, William H.
AU - Schwartz, David L.
AU - Weber, Randal S.
AU - Buchholz, Thomas A.
PY - 2009/8
Y1 - 2009/8
N2 - Background. In patients with head and neck cancer, radiation treatment (RT) is a risk factor for hypothyroidism. However, the specific magnitude of risk after RT in older patients is not known. Methods. We identified 5916 patients (age > 65 years) from SEER-Medicare diagnosed with head and neck cancer from 1992 to 2002. Proportional hazards models compared hypothyroidism risk after any RT versus surgery alone. Results. In patients treated with RT, 5-year incidence of hypothyroidism was 20% and 10-year incidence was 59%; in patients treated with surgery alone, incidence was 7% and 39% (p < .001). Patients treated with RT had increased adjusted risk (hazard ratio [HR] = 2.14; 95% confidence interval [CI] = 1.74-2.62), persisting for up to 10 years of follow-up (HR = 1.85, 95% CI = 1.39-2.44 from 5 to 10 years). Conclusion. In older patients with head and neck cancer, RT is associated with elevated hypothyroidism risk. As onset may be delayed for years, patients may require lifelong thyroid function screening after treatment.
AB - Background. In patients with head and neck cancer, radiation treatment (RT) is a risk factor for hypothyroidism. However, the specific magnitude of risk after RT in older patients is not known. Methods. We identified 5916 patients (age > 65 years) from SEER-Medicare diagnosed with head and neck cancer from 1992 to 2002. Proportional hazards models compared hypothyroidism risk after any RT versus surgery alone. Results. In patients treated with RT, 5-year incidence of hypothyroidism was 20% and 10-year incidence was 59%; in patients treated with surgery alone, incidence was 7% and 39% (p < .001). Patients treated with RT had increased adjusted risk (hazard ratio [HR] = 2.14; 95% confidence interval [CI] = 1.74-2.62), persisting for up to 10 years of follow-up (HR = 1.85, 95% CI = 1.39-2.44 from 5 to 10 years). Conclusion. In older patients with head and neck cancer, RT is associated with elevated hypothyroidism risk. As onset may be delayed for years, patients may require lifelong thyroid function screening after treatment.
KW - Head and neck cancer
KW - Hypothyroidism
KW - Radiation
KW - Survivorship
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=67650436172&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67650436172&partnerID=8YFLogxK
U2 - 10.1002/hed.21066
DO - 10.1002/hed.21066
M3 - Article
C2 - 19360741
AN - SCOPUS:67650436172
VL - 31
SP - 1031
EP - 1038
JO - Head and Neck
JF - Head and Neck
SN - 1043-3074
IS - 8
ER -