中国现代医学杂志2018，Vol.28Issue(9)：70-75,6.DOI:10.3969/j.issn.1005-8982.2018.09.013
头颈部肿瘤放疗后甲状腺损伤危险因素分析
Risk factors for prediction of thyroid injury after radiotherapy in head/neck tumors
摘要
Abstract
Objective To investigate the risk factors of thyroid injury after radiotherapy in patients with head/ neck cancer. Methods Totally 58 patients with head/neck cancer who received intensity-modulated radiation therapy (IMRT) in our hospital were included in this study. The occurrence of thyroid injury during radiotherapy and follow-up was recorded, along with information including age, gender, tumor type, stage, thyroid radiation dose and volume parameter. Logistic multivariate analysis was performed to screen the independent factors to predict the thyroid injury. Results The mean follow-up time was 17.50 months; 5 cases died and 27 cases experienced thyroid injury (27/58, 46.55％). Twenty-three cases had hypothyroidism, while the other 4 cases were hyperthyroidism who were all diagnosed with Hodgkin's lymphoma. The Logistic multivariate analysis showed that age, MTD and V40 were the independent factors (R=0.116, 5.894, 9.375, P = 0.000, respectively). AUC of Age, MTD, and V40 were 0.596, 0.741 and 0.714, respectively. Sensitivities of age, MTD and V40 were 0.516, 0.741 and 0.926, respectively. Specificity of Age, MTD, and V40 were 0.815, 0.645 and 0.548, respectively. The best cut-off value of Age, MTD and V40 were 39.5, 45.5 Gy and 69.5％, respectively. Conclusion MTD and V40 are the risk factors while age is a protective factor for thyroid injury after radiotherapy in head/neck tumors. MTD exceeding 45.5 Gy and V40 over 69.5％ indicates high chance of thyroid damage.关键词
甲状腺受照剂量/体积/调强放射治疗/甲状腺损伤Key words
thyroid radiation dose/volume/imrt/thyroid injury分类
医药卫生引用本文复制引用
皮国良,何汉平,毕建平,李莹,黎艳萍..头颈部肿瘤放疗后甲状腺损伤危险因素分析[J].中国现代医学杂志,2018,28(9):70-75,6.基金项目
湖北省卫生和计划生育委员会科研项目(No: WJ2017M145) （No: WJ2017M145）
