摘要
目的探讨鼻咽癌患者调强放射治疗后早期甲状腺功能的变化情况,为甲状腺功能保护提供依据。方法收集经病理证实、排除基础甲状腺疾病且接受IMRT治疗的鼻咽癌患者。分析对比放疗前后TT3和TT4水平。结果全组患者治疗前、后TT3水平分别为1.83 IU/L、1.69 IU/L,治疗前、后TT4水平分别为124.66 IU/L、127.23 IU/L。其中150例(59.8%)治疗后TT3水平下降,变化具有统计学差异(P=0.001)。N3患者放疗后血清TT3及TT4水平均明显降低(P值分别为0.043、0.032)。结论 IMRT模式下,鼻咽癌患者放疗结束时甲状腺激素降低,N3患者尤为明显。N3患者可运用VMAT/Tomotherapy等技术降低甲状腺照射剂量,且应早期监测甲状腺激素水平,发现问题及早干预。
Objective To evaluate the changes of the thyroid function shortly after intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma,for a better protection away from the radiation-induced hypothyroidism.Methods A total of 251 nasopharyngeal carcinoma（ NPC） were collected.All patients were pathologically confirmed without basic thyroid disease and all received intensity-modulated radiotherapy（ IMRT）.Analyzed and compared the level of TT3 and TT4 before and after IMRT by paired sample T-test comparison for the whole group and the N3 group.Results In the whole group,the level of TT3 before and after IMRT were 1.83 IU / L and 1.69 IU / L.The level of TT4 were 124.66 IU / L and 127.23 IU / L,respectively.There were 150（ 59.8%） patients developed TT3 decreased after treatment,with a statistically difference（ P value 0.001）.In the N3 group,the level of serum TT3 and TT4 were significantly lower after IMRT when compared with the levels before IMRT（ P values were 0.043 and 0.032,respectively）.Conclusion In the era of IMRT,thyroid hormones start to decrease at the end of radiotherapy in patients with nasopharyngeal carcinoma,especially the N3 diseases.The patients with N3 diseases could use the technology of VMAT / Tomotherapy to reduce the dose of thyroid.At the meantime,thyroid hormone levels should be monitored early which allows early treatment.
出处
《实用癌症杂志》
2016年第11期1799-1802,共4页
The Practical Journal of Cancer
基金
国家重点专科资助及福建省临床重点专科项目资助(编号:81341108)
国家自然科学基金(编号:81470134)
福建省自然科学基金(编号:2014J01406)
福建省科技厅引导性项目(编号:2015Y0051)
福建省卫生厅青年课题(2012-1-6)
关键词
鼻咽癌
调强放疗
甲状腺功能减退
Nasopharyngeal carcinoma（NPC）
Intensity-modulated radiotherapy（IMRT）
Radiation-induced hypothyroidism
