Early thyroid function alterations after external beam radiation therapy - A Prospective, Observational Study

Dr Nilotpal Chakravarty; Dr Manu Tiwari; Dr Amit Nachankar; Dr Sharad Bhatnagar; Dr Mayuri Jain

Volume : X, Issue : VI, June - 2020

Early thyroid function alterations after external beam radiation therapy - A Prospective, Observational Study

Dr Nilotpal Chakravarty, Dr Manu Tiwari, Dr Amit Nachankar, Dr Sharad Bhatnagar, Dr Mayuri Jain

Abstract :

Background: External beam radiation therapy (EBRT) is commonly used in the management of head and neck squamous cell carcinoma (HNSCC) and affects the thyroid gland. We conducted this study to evaluate the spectrum of early thyroid dysfunction following EBRT. Methods: We included 40 patients (any age, HNSCC requiring EBRT) in this prospective, observational study. All patients underwent thyroid function tests before and after EBRT at serial intervals of 1, 3 and 6 months. Descriptive statistics were used for presenting the data. Results: The study population (37M, 3F) had a mean age of 57 ± 3.3 yrs. The mean TSH level fell initially and rose again at 3 and 6 months (mean TSH was 1.55, 1.34, 1.71 and 2.4 mU/L at 0, 1, 3 and 6 months respectively). Free thyroid hormones did not change significantly during the observation period. Four patients had low TSH at 1 month, which persisted in only one patient during the follow up at 6 months. Two patients developed hypothyroidism and none of the patients were symptomatic for thyroid dysfunction. Conclusion: Transient thyroid alterations have been observed in patients after EBRT and the disease often remains silent. Frequent assessment for thyroid dysfunction should be done in patients undergoing EBRT for HNSCC.