Research progress on radiation-induced hypothyroidism in nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Hypothyroidism is a common complication in patients with nasopharyngeal carcinoma after radiotherapy, and its incidence is mainly associated with clinical factors, such as radiotherapy, chemotherapy, sex, age and clinical stage, etc. The normal tissue complication probability models of radiation-induced hypothyroidism can be established by using related factors, which can be employed to screen the high-risk patients. In this article, clinical factors related to radiation-induced hypothyroidism were summarized, aiming to prevent the early radiation-induced hypothyroidism, reduce the incidence of hypothyroidism and improve the quality of life of patients.

Preliminary results of SBRT treatment of pulmonary oligometastasis from head and neck tumors / 中华放射肿瘤学杂志

Objective:To preliminarily evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for pulmonary oligometastatic tumors from head and neck carcinoma.Methods:Clinical data of 24 patients with pulmonary oligometastasis from head and neck carcinoma undergoing SBRT in Zhejiang Cancer Hospital from January 2014 to May 2019 were retrospectively analyzed. Survival analysis was performed by Kaplan- Meier method. Results:Among the 24 patients, 12 cases were diagnosed with nasopharyngeal origin and 12 cases of non-nasopharyngeal origin. A total of 34 pulmonary metastatic lesions were treated with SBRT. The median follow-up time was 19.5 months. Thirteen cases developed new lesions after SBRT, and 9 of them occurred within 1 year after SBRT treatment. The actual 1-year local control rate was 95%. The median progression-free survival was 15.2 months, and the 1-and 2-year progression-free survival were 59% and 46%, respectively. The 2-and 3-years overall survival rate at were 71% and 51% fter lung metastasis, respectively. Univariate analysis showed that the patients with primary lesions located in nasopharynx and disease-free interval of more than 1 year had survival advantage. No more than grade 3 radiation-induced injury was observed in the whole cohort after SBRT, and the incidence of mild radiation-induced injury was 13%.Conclusions:SBRT is safe and effective in the treatment of pulmonary oligometastatsis from head and neck carcinoma, and it may be more effective for patients with primary tumors located in nasopharynx.

Study of related factors of radiation-induced hypothyroidism in nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To explore the main factors of hypothyroidism after radiotherapy and to identify the optimal thyroid dosimetric parameters by analyzing the dosimetric parameters of the thyroid.Methods:The general clinical characteristics and dosimetric parameters of 206 patients with nasopharyngeal carcinoma treated in Cancer Hospital of University of Chinese Academy of Sciences were collected, and the correlation between them and the incidence of hypothyroidism was analyzed.Results:The incidence of hypothyroidism in patients with nasopharyngeal carcinoma after radiotherapy was 50.49%(104/206). Univariate analysis showed that gender, N-stage, volume, mean dose, V 20Gy, V 25Gy, V 30Gy, V 35Gy, V 40Gy, V 45Gy of thyroid were associated with the incidence of hypothyroidism. Multivariate analysis demonstrated that volume (≤12.82 cm 3) and mean dose of thyroid were the independent risk factors of hypothyroidism. Mean dose of thyroid combined with volume could significantly predict the incidence of hypothyroidism after radiotherapy. Conclusion:Mean dose of thyroid ≤ 47.21 Gy is the optimal dosimetric parameter for radiation-induced hypothyroidism, especially the patients with thyroid volume ≤ 12.82 cm 3 should pay more attention to the protection of thyroid gland during radiotherapy.

Research progress on radiotherapy-induced hippocampal damage and cognitive dysfunction in nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Radiation-induced cognitive dysfunction is a common complication in patients with nasopharyngeal carcinoma after undergoing radiotherapy, which has been proven to be associated with neurogenesis dysfunction, oligodendrocyte loss, vascular damage and abnormal cytokine expression. With the development of medicine, functional magnetic resonance image (fMRI) can detect the early lesions of cognitive dysfunction. Hippocampus-sparing technology and drug therapy (memantine, donepezil and bevacizumab) can mitigate radiation-induced cognitive dysfunction. In this article, the pathogenesis, neuroimaging, radiodosimetry and therapies of radiotherapy-induced cognitive dysfunction in nasopharynal carcinoma patients were reviewed.

Early screening of high-risk patients with radiation-induced hypothyroidism in nasopharyngeal carcinoma by hematological examination / 中华放射肿瘤学杂志

Objective:To analyze the relationship between hematological examination combined with clinical factors and radiation-induced hypothyroidism (HT) in patients with nasopharyngeal carcinoma (NPC).Methods:Clinical data of 206 patients with NPC who received radiotherapy in Cancer Hospital of University of Chinese Academy of Sciences between January 2015 to August 2018 were retrospectively analyzed. The correlation between general clinical data, hematological examination and HT was analyzed to establish a hematological prediction model.Results:Univariate analysis showed that sex, N-stage, thyroid volume, average dose, V 20Gy, V 25Gy, V 30Gy, V 35Gy, V 40Gy, V 45Gy, fibrinogen content, cholinesterase and neutrophil count were closely associated with the incidence of HT. Multivariate analysis showed that thyroid volume, fibrinogen content and cholinesterase were the independent predictors of HT. Conclusion:The combination of sex, N-stage, thyroid volume, dose parameters, fibrinogen content, cholinesterase, neutrophil percentage and neutrophil count can predict the incidence of HT (AUC=0.777).