ABSTRACT
The paper presents the results of the study concerning thyroid gland function of the patients suffering from larynx cancer treated with: a) surgery only, b) surgery with further radiotherapy with radical doses 5000-6500 cGy, c) radiotherapy along with radical doses 6500-7200 cGy. Thyroid gland function was evaluated by measurement of: a) hTSH, FT3, FT4, b) serum lipids concentration. The hTSH concentration was evaluated by immunoradiometric method whereas FT3 and FT4 by DELFIA techniques (deleted fluorescence). 162 patients (M-148, F-14) were examined. Average age was 57 (min.-30, max.-80). The patients were divided into two groups. The first group (n = 90) involved those who had been examined once at different time since the end of treatment (retrospective examinations). The patients who had been examined before as well as after treatment were established as the second group (n = 72) (prospective examinations). In this case the examinations are still being continued and they are carried out at: a) 1, b) 1-6, c) 6-12, d) 12-24, e) longer than 24 months after completion of treatment. Our preliminary data show that hypothyroidism (mostly subclinical) occurs seldom (7% of all the cases) in the early phase (up to 1 month) after surgical treatment and gets normal spontaneously (up to 6 months). After radiotherapy only--no subclinical hypothyroidism was observed. Interestingly, the combined treatment seems to be the most frequent cause of subclinical hypothyroidism. Its frequency increases (up to 47%) with the length of time since the conclusion of treatment (2 years and longer). Because of continuation of our examinations the presented data are still preliminary and they will be verified in the next paper. We also tried to explain the pathogenesis of subclinical hypothyroidism on the basis of histopathologic examination of thyroid tissue derived from the patients (after combined treatment and after radiotherapy) during further total laryngectomy performed because of neoplasm renewal.
