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Hypothyroidism in older patients with head and neck cancer after treatment with radiation: A population‐based study
Author(s) -
Smith Grace L.,
Smith Benjamin D.,
Garden Adam S.,
Rosenthal David I.,
Sherman Steven I.,
Morrison William H.,
Schwartz David L.,
Weber Randal S.,
Buchholz Thomas A.
Publication year - 2009
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21066
Subject(s) - medicine , incidence (geometry) , head and neck cancer , hazard ratio , confidence interval , thyroid cancer , radiation therapy , cancer , late effect , population , risk factor , surgery , relative risk , physics , environmental health , optics
Background In patients with head and neck cancer, radiation treatment (RT) is a risk factor for hypothyroidism. However, the specific magnitude of risk after RT in older patients is not known. Methods We identified 5916 patients (age > 65 years) from SEER‐Medicare diagnosed with head and neck cancer from 1992 to 2002. Proportional hazards models compared hypothyroidism risk after any RT versus surgery alone. Results In patients treated with RT, 5‐year incidence of hypothyroidism was 20% and 10‐year incidence was 59%; in patients treated with surgery alone, incidence was 7% and 39% ( p < .001). Patients treated with RT had increased adjusted risk (hazard ratio [HR] = 2.14; 95% confidence interval [CI] = 1.74–2.62), persisting for up to 10 years of follow‐up (HR = 1.85, 95% CI = 1.39–2.44 from 5 to 10 years). Conclusion In older patients with head and neck cancer, RT is associated with elevated hypothyroidism risk. As onset may be delayed for years, patients may require lifelong thyroid function screening after treatment. © 2009 Wiley Periodicals, Inc. Head Neck, 2009