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Symposium on malignancy. V. Hypothyroidism following combined therapy in carcinoma of the laryngopharynx
Author(s) -
Murken Roger E.,
Duvall Arndt J.
Publication year - 1972
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-197207000-00020
Subject(s) - medicine , radiation therapy , thyroid carcinoma , surgery , malignancy , thyroidectomy , thyroid , laryngectomy , thyroid function , carcinoma , larynx
There is an increasing trend to combine high dosage pre‐operative radiation with radical surgery for carcinoma of the laryngopharynx. This could be a hazard to thyroid function, especially when surgery includes a partial thyroidectomy. We initiated a study in 1969 to determine the effect on thyroid function produced by external radiation of the neck followed by radical surgery of the laryngopharynx. A group of 24 patients previously treated with external radiation and/or surgery for carcinoma of the laryngopharynx, and without recurrence, were studied with laboratory determinations of PBI and total serum thyroxine (T 4 ). Out of 12 patients treated with 3,800 to 5,500 tissue rads of pre‐operative Cobalt 60 to the neck, laryngectomy and hemithyroidectomy, eight or 66 percent were found to be hypothyroid at varying time periods (two to 74 months) after treatment. A PBI determination was done on five of these patients and ranged from 0.8 to 3.2 mcg percent (n = 4.0 to 8.0). A total serum thyroxine was done for all eight patients. Those performed by the column method ranged from 0.8 to 2.5 mcg percent thyroxine iodine (n = 2.9 to 6.4) and those performed by the Murphy‐Pattee method ranged from 1.3 to 4.9 meg percent thyroxine (n = 5.0 to 13.7). Two of the other 12 patients were found to be hypothyroid. One patient received 7,000 tissue rads of Cobalt 60 and no surgery. One year following therapy his thyroid studies were normal, but two years after therapy his studies were within the hypothyroid range. The other patient found to be hypothyroid had a laryngectomy and hemithyroidectomy with no pre‐op‐erative Cobalt 60. The operative report indicated that both the superior and inferior thyroid vessels to the remaining lobe were ligated.