Hypothyroidism in older patients with head and neck cancer after treatment with radiation: A population-based study

Grace L. Smith; Benjamin D. Smith; Adam S. Garden; David I. Rosenthal; Steven I. Sherman; William H. Morrison; David L. Schwartz; Randal S. Weber; Thomas A. Buchholz

doi:10.1002/hed.21066

Hypothyroidism in older patients with head and neck cancer after treatment with radiation: A population-based study

Grace L. Smith, Benjamin D. Smith, Adam S. Garden, David I. Rosenthal, Steven I. Sherman, William H. Morrison, David L. Schwartz, Randal S. Weber, Thomas A. Buchholz

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

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	https://doi.org/10.1002/hed.21066
State	Published - Aug 1 2009

Keywords

Head and neck cancer
Hypothyroidism
Radiation
Survivorship
Toxicity

ASJC Scopus subject areas

Otorhinolaryngology

Access to Document

10.1002/hed.21066

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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, 01.08.2009, p. 1031-1038.

Research output: Contribution to journal › Article › peer-review

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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.",

keywords = "Head and neck cancer, Hypothyroidism, Radiation, Survivorship, Toxicity",

author = "Smith, {Grace L.} and Smith, {Benjamin D.} and Garden, {Adam S.} and Rosenthal, {David I.} and Sherman, {Steven I.} and Morrison, {William H.} and Schwartz, {David L.} and Weber, {Randal S.} and Buchholz, {Thomas A.}",

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AU - Sherman, Steven I.

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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.

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