Cited 18 times in
Risk of Hypothyroidism in Women After Radiation Therapy for Breast Cancer
DC Field | Value | Language |
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dc.contributor.author | 김용배 | - |
dc.contributor.author | 김지훈 | - |
dc.contributor.author | 김진성 | - |
dc.contributor.author | 변화경 | - |
dc.contributor.author | 장지석 | - |
dc.contributor.author | 최서희 | - |
dc.contributor.author | 홍남기 | - |
dc.contributor.author | 홍채선 | - |
dc.date.accessioned | 2021-09-29T00:47:07Z | - |
dc.date.available | 2021-09-29T00:47:07Z | - |
dc.date.issued | 2021-06 | - |
dc.identifier.issn | 0360-3016 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/184034 | - |
dc.description.abstract | Purpose: To study the hypothyroidism risk after adjuvant radiation therapy (RT) and the association of different RT targets with hypothyroidism risk. Methods: We studied 4073 women treated with adjuvant RT for breast cancer from 2007 to 2016. The primary endpoint was hypothyroidism development after RT. Patients were divided and analyzed into 3 groups: whole breast (WB)-alone (n = 2468), regional node irradiation (RNI)-Lv.4 (n = 215; cranial border at the subclavian artery, according to the European Society for Radiotherapy and Oncology consensus guideline), and RNI-supraclavicular lymph node (SCL) (n = 1390; cranial border at the cricoid cartilage). In general, RNI-Lv.4 was used in the patients with high-risk pN0 and pN1 breast cancer. In auxiliary analysis, the mean thyroid dose was estimated in each group (total n = 600, 200 from each group). All the doses were converted to the equivalent dose in 2 Gy fractions (EQD2) with α/β ratios of 3. Results: The median follow-up duration was 84 months (WB-alone, 84 months; RNI-Lv.4, 44 months; RNI-SCL, 91 months). The 3-year hypothyroidism incidence rate differed significantly between the RNI-SCL and WB-alone groups (2.2% vs 0.8%; Bonferroni corrected P [Pc] < .001) but not between the RNI-Lv.4 and WB-alone groups (0.9% vs 0.8%; Pc > .05). The Cox model revealed an adjusted hazard ratio of 2.25 (95% CI, 1.49-3.38) for RNI-SCL vs WB-alone, 1.69 (95% CI, 1.12-2.56) for adjuvant systemic therapies, and 2.07 (95% CI, 1.07-3.99) for age <60 years. In the subgroup analysis, the hypothyroidism risk became more prominent in patients aged <60 years. The mean exposure doses to the thyroid were 0.23 versus 1.93 versus 7.89 Gy (EQD2) for the WB-alone versus RNI-Lv.4 versus RNI-SCL groups (P < .001). No statistically different locoregional recurrence rates were seen between groups (5-year rate: <3%). Conclusions: The risk of hypothyroidism increases after RNI-SCL for breast cancer but not after RNI-Lv 4. These data support routine contouring of the thyroid in the RNI setting, and future studies are required to develop optimal dose-volume constraints. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Elsevier Science Inc. | - |
dc.relation.isPartOf | INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Risk of Hypothyroidism in Women After Radiation Therapy for Breast Cancer | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Radiation Oncology (방사선종양학교실) | - |
dc.contributor.googleauthor | Seo Hee Choi | - |
dc.contributor.googleauthor | Jee Suk Chang | - |
dc.contributor.googleauthor | Hwa Kyung Byun | - |
dc.contributor.googleauthor | Nak-Hoon Son | - |
dc.contributor.googleauthor | Chae-Seon Hong | - |
dc.contributor.googleauthor | Namki Hong | - |
dc.contributor.googleauthor | Ye-In Park | - |
dc.contributor.googleauthor | Jihun Kim | - |
dc.contributor.googleauthor | Jin Sung Kim | - |
dc.contributor.googleauthor | Yong Bae Kim | - |
dc.identifier.doi | 10.1016/j.ijrobp.2020.12.047 | - |
dc.contributor.localId | A00744 | - |
dc.contributor.localId | A05823 | - |
dc.contributor.localId | A04548 | - |
dc.contributor.localId | A05136 | - |
dc.contributor.localId | A04658 | - |
dc.contributor.localId | A04867 | - |
dc.contributor.localId | A04388 | - |
dc.contributor.localId | A05846 | - |
dc.relation.journalcode | J01157 | - |
dc.identifier.eissn | 1879-355X | - |
dc.identifier.pmid | 33412261 | - |
dc.identifier.url | https://www.sciencedirect.com/science/article/pii/S036030162034743X | - |
dc.contributor.alternativeName | Kim, Yong Bae | - |
dc.contributor.affiliatedAuthor | 김용배 | - |
dc.contributor.affiliatedAuthor | 김지훈 | - |
dc.contributor.affiliatedAuthor | 김진성 | - |
dc.contributor.affiliatedAuthor | 변화경 | - |
dc.contributor.affiliatedAuthor | 장지석 | - |
dc.contributor.affiliatedAuthor | 최서희 | - |
dc.contributor.affiliatedAuthor | 홍남기 | - |
dc.contributor.affiliatedAuthor | 홍채선 | - |
dc.citation.volume | 110 | - |
dc.citation.number | 2 | - |
dc.citation.startPage | 462 | - |
dc.citation.endPage | 472 | - |
dc.identifier.bibliographicCitation | INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.110(2) : 462-472, 2021-06 | - |
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