Evaluation of thyroid gland as an organ at risk after breast cancer radiotherapy: a systematic review and meta-analysis
- 113 Downloads
Radiotherapy can often lead to thyroid dysfunction. Some studies demonstrated that treatment of breast cancer by RT can expose thyroid gland to high doses of radiation. The aim of this systematic review is to evaluate consideration of thyroid gland as an organ at risk.
In this systematic review and meta-analysis to select initial studies, a comprehensive search by two independent reviewers was performed. Electronical databases following: Web of Science, Google Scholar, Scopus, PubMed, Elsevier, Embase, ProQuest and Persian databases such as Iranmedex, Magiran, and SID were searched. All searches were restricted to English language between 1985 and 2017. A random effect meta-analysis is applied to estimate pooled effect size across initial studies. Funnel plot with Egger’s test is used to assess potential publication bias.
Totally, five studies (478 samples) were included in meta-analysis. The meta-analyses of result showed that thyroid gland is affected by radiotherapy significantly and the TSH increased after radiotherapy (z = 2.68, P = 0.007). The pooled estimate of difference mean for TSH was 0.90 (95% CI 0.24, 1.55). In studies among patients with breast cancer RT, hypothyroidism was reported more than other thyroid disorders. There was not showed possibility publication bias among studies (P > 0.05).
This study demonstrated that thyroid gland is affected by radiotherapy significantly and the TSH increased after radiotherapy. Protecting thyroid gland during radiation and follow-up of patients with breast cancer RT are suggested for the assessment of thyroid gland dysfunction.
KeywordsThyroid dysfunction Breast cancer Radiotherapy Organ at risk
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval (research involving human participants and/or animals)
This work has not any human or animal participants.
There is no consent for this work.
- 4.Cardoso LJSF, Martine J, Piccart–William C, Wood–Chie-Mien H. Breast cancer and molecular medicine. Switzerland: Springer; 2006.Google Scholar
- 12.Beck-Peccoz Paolo, Amr Sania. M. Margarida Menezes-Ferreira, Giovanni Faglia, and Bruce D. Weintraub. Decreased receptor binding of biologically inactive thyrotropin in central hypothyroidism. Effect of treatment with thyrotropin-releasing hormone. N Engl J Med. 1985;312:1085–90.CrossRefPubMedGoogle Scholar
- 14.Roozbeh N, Azizi M, Darvish L. Pregnancy outcome of abnormal nuchal translucency: a systematic review. J of Clin and Diag Res. 2017;11(3):12–6.Google Scholar
- 20.Akureki S, Ibrahim Babalioglu I, Kose K, Saban C. GOKCE. Thyroid dysfunction following supraclavicular irradiation in the management of carcinoma of the breast. Int J of Hema Oncol 2014; 24(2):139–144.Google Scholar
- 24.Kim SS, Kim SJ, Bae YT, Lee JY, Kim BH, Kim YK, et al. Factors associated with the development of new onset diffuse thyroid F18-Fluorodeoxyglucose uptake after treatment of breast cancer in patients without a history of thyroid disease or thyroid dysfunction. Thyroid Radiol Nucl Med. 2012;22(1):53–8.Google Scholar
- 25.Srikantia N, Rishi K, Janaki MG, Bilimagga R, Ponni A, Rajeev AG, et al. How common is hypothyroidism after external radiotherapy to neck in head and neck cancer patients. J Cancer Res Ther. 2011;32(3):143–8.Google Scholar