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Association Between Thyroid Radiation Dose and Hypothyroidism in Breast Cancer Patients Undergoing Volumetric Modulated Arc Therapy for Regional Nodal Irradiation
- Title
- Association Between Thyroid Radiation Dose and Hypothyroidism in Breast Cancer Patients Undergoing Volumetric Modulated Arc Therapy for Regional Nodal Irradiation
- Authors
- Koh, Hyeon Kang; Park, Younghee; Koo, Taeryool; Cheong, Kwang-Ho; Lee, Me Yeon; Park, Hae Jin; Kim, Kyoung Ju; Park, Soah; Han, Taejin; Kang, Sei-Kwon; Ha, Boram; Yoon, Jai-Woong; Kim, Me Young; Bae, Hoonsik
- Ewha Authors
- 박영희
- SCOPUS Author ID
- 박영희
- Issue Date
- 2023
- Journal Title
- IN VIVO
- ISSN
- 0258-851X
1791-7549
- Citation
- IN VIVO vol. 37, no. 5, pp. 2340 - 2346
- Keywords
- Hypothyroidism; breast cancer; radiotherapy; volumetric modulated arc therapy
- Publisher
- INT INST ANTICANCER RESEARCH
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background/Aim To investigate the association between the thyroid dysfunction and thyroid radiation dose in regional nodal irradiation (RNI) using volumetric modulated arc therapy (VMAT) for breast cancer.Patients and Methods We reviewed medical data of 67 patients with breast cancer who underwent curative surgery followed by adjuvant radiotherapy, including RNI using VMAT, between 2018 and 2021. All patients had normal thyroid functional test results, including thyroid stimulating hormone (TSH), T3, and free-T4. We defined subclinical hypothyroidism as increased TSH with or without decreased levels of free-T4 and T3 after the completion of VMAT. We calculated dose-volume histogram parameters (DVHPs), including the mean dose and relative thyroid volume receiving at least 10, 20, 30, and 40 Gy.Results The median follow-up time was 23.2 months. The 3-year locoregional failure-free survival, progression-free survival, and overall survival rates were 96.3%, 94.7%, and 96.2%, respectively. The mean thyroid dose was 21.4 Gy (range=11.5-29.4 Gy). Subclinical hypothyroidism was noted in 14 patients (20.9%) and the median time to the event was 4.1 months. Among the DVHPs, the relative volume receiving >= 20 Gy (V-20Gy) was associated with subclinical hypothyroidism. The 2-year rates of subclinical hypothyroidism were 24.8% and 59.1% in patients with V-20Gy <= 46.3% and >46.3%, respectively.Conclusion A significant proportion of patients with breast cancer developed subclinical hypothyroidism after undergoing VMAT for RNI. Our findings highlight the importance of considering the thyroid as an organ at risk for VMAT planning, and suggest that V-20Gy could be a useful dose-volume constraint.
- DOI
- 10.21873/invivo.13338|http://dx.doi.org/10.21873/invivo.13338
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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