Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press107610.17650/2222-1468-2025-15-2-92-98REVIEWОБЗОРНАЯ СТАТЬЯPost-radiation changes in thyroid function during treatment of head and neck tumors: current state of the problemПостлучевые изменения функции щитовидной железы при лечении опухолей головы и шеи: современное состояние проблемыhttps://orcid.org/0009-0004-0349-3653ZabrovskayaS. A.ЗабровскаяС. А.
Russian Federation

Svetlana Anatolyevna Zabrovskaya

3 2nd Botkinsky Proezd, Moscow 125284

Светлана Анатольевна Забровская

125284 Москва, 2-й Боткинский проезд, 3

zabrovskaya.sa@gmail.comhttps://orcid.org/0000-0002-9181-7811GevorkovA. R.ГеворковА. Р.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0002-2764-5189ZaitsevaN. A.ЗайцеваН. А.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

FedoseevaA. A.ФедосееваА. А.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0002-4751-6923BoykoA. V.БойкоА. В.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0002-4880-0213KhmelevskiyE. V.ХмелевскийЕ. В.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0001-8784-8415KaprinA. D.КапринА. Д.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

P.A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Ministry of Health of RussiaМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России0907202515292980907202509072025Copyright ©; 2025, Zabrovskaya S.A., Gevorkov A.R., Zaitseva N.A., Fedoseeva A.A., Boyko A.V., Khmelevskiy E.V., Kaprin A.D.Copyright ©; 2025, Забровская С.А., Геворков А.Р., Зайцева Н.А., Федосеева А.А., Бойко А.В., Хмелевский Е.В., Каприн А.Д.2025Zabrovskaya S.A., Gevorkov A.R., Zaitseva N.A., Fedoseeva A.A., Boyko A.V., Khmelevskiy E.V., Kaprin A.D.Забровская С.А., Геворков А.Р., Зайцева Н.А., Федосеева А.А., Бойко А.В., Хмелевский Е.В., Каприн А.Д.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/1076

Post-radiation hypothyroidism is a common complication of treatment of head and neck tumors: its incidence is 6–50 %. Even subclinical hypothyroidism is associated with such cardiovascular diseases as ischemic heart disease and myocardial infarction. This pathology can significantly affect both quality of life and lifespan of patients who underwent radiation therapy.The article presents results of studies on identification of predictors of post-radiation hypothyroidism, as well as clinical cases demonstrating results of radiation therapy in head and neck cancer treatment.

Постлучевой гипотиреоз является распространенным осложнением лечения опухолей опухолями головы и шеи: частота его развития составляет 6–50 %. Даже субклинический гипотиреоз ассоциирован с такими заболеваниями сердечно-сосудистой системы, как ишемическая болезнь сердца и инфаркт миокарда. Данная патология может значимо влиять не только на качество, но и на продолжительность жизни пациентов, перенесших лучевую терапию.В статье представлены результаты исследований, посвященных определению предикторов постлучевого гипотиреоза, а также клинические случаи, демонстрирующие результаты лучевой терапии при раке головы и шеи.

hypothyroidismradiation therapyhead and neck tumorгипотиреозлучевая терапияопухоль головы и шеиTsyb A.F., Matvеenko E.G., Nestayko G.V., Gorobets V.F. Intermittent hypothyroidism (scientific review). Radiatsiya i risk = Radiation and Risk 1997;10:61–83. (In Russ.).Цыб А.Ф., Матвеенко Е.Г., Нестайко Г.В., Горобец В.Ф. Пострадиационный гипотиреоз (научный обзор). Радиация и риск 1997;10:61–83.Lee V., Chan S.Y., Choi C.W. et al. Dosimetric predictors of hypothyroidism after radical intensity-modulated radiation therapy for non-metastatic nasopharyngeal carcinoma. Clin Oncol 2016;28(8):52–60. DOI: 10.1016/j.clon.2016.05.004McDowell L.J., Rock K., Xu W. et al. Long-term late toxicity, quality of life, and emotional distress in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 2018;102(2):340–52. DOI: 10.1016/j.ijrobp.2018.05.060Troshina E.A., Yukina M.Yu., Ogneva N.A., Mazurina N.V. Disorders of the thyroid gland and the cardiovascular system. Klinicheskaya i eksperimental’naya tireoidologiya = Clinical and Experimental Thyroidology 2010;6(1):12–9. (In Russ.).Трошина Е.А., Юкина М.Ю., Огнева Н.А., Мазурина Н.В. Нарушения функции щитовидной железы и сердечно-сосудистая система. Клиническая и экспериментальная тиреоидология 2010;6(1):12–9.Verbovoy A.F., Sharonova L.A., Kosareva O.V. et al. The state of the cardiovascular system in hypothyroidism. Klinicheskaya meditsina = Clinical Medicine 2016;94(7):497–502. (In Russ.).Вербовой А.Ф., Шаронова Л.А., Косарева О.В. и др. Состояние сердечно-сосудистой системы при гипотиреозе. Клиническая медицина 2016;94(7):497–502.Biondi B., Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrin 2004;24(1):1–13. DOI: 10.1385/ENDO:24:1:001Gencer B., Collet T.H., Virgini V. et al. Thyroid Studies Collaboration. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation 2012;126(9):1040–9. DOI: 10.1161/CIRCULATIONAHA.112.096024Horodynska O.Yu. Syndrome of hypothyroidism as a factor of cardiovascular pathology development (literature review). 2017;13(7):503–5.Tariq K., Rana F., Zaiden R. et al. Radiation induced hypothyroidism and its relationship with gender and smoking history in head and neck cancer patients. J Nucl Med Radiat Ther 2014;5(3):113–7. DOI: 10.14740/wjon835wLertbutsayanukul C., Kitpanit S., Prayongrat A. et al. Validation of previously reported predictors for radiation-induced hypothyroidism in nasopharyngeal cancer patients treated with intensity-modulated radiation therapy, a post hoc analysis from a phase III randomized trial. J Radiat Res 2018;59(4):446–55. DOI: 10.1093/jrr/rry036Zhou L., Chen J., Shen W. et al. Thyroid V 50 is a risk factor for hypothyroidism in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: a retrospective study. Radiat Oncol 2020;15(1):68. DOI: 10.1186/s13014-020-01490-xFujiwara M., Kamikonya N., Odawara S. et al. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases. J Radiat Res 2015;56(3):577–82. DOI: 10.1093/jrr/rrv006Zhai R.-P., Kong F.-F., Du C.-R. et al. Radiation-induced hypothyroidism after IMRT for nasopharyngeal carcinoma: clinical and dosimetric predictors in a prospective cohort study. Oral Oncol 2017;68:44–9. DOI: 10.1016/j.oraloncology.2017.03.005Murthy V., Narang K., Ghosh-Laskar S. et al. Hypothyroidism after 3-dimensional conformal radiotherapy and intensitymodulated radiotherapy for head and neck cancers: prospective data from 2 randomized controlled trials. Head Neck 2014;36(11):1573–80. DOI: 10.1002/hed.23482Ling S., Bhatt A.D., Brown N.V. et al. Correlative study of dose to thyroid and incidence of subsequent dysfunction after head and neck radiation. Head Neck 2017;39(3):548–54. DOI: 10.1002/hed.24643Chow J.C.H., Cheung K.M., Cheung G.T.C. et al. Dose-volume predictors of post-radiation primary hypothyroidism in head and neck cancer: a systematic review. Clin Transl Radiat Oncol 2022;33:83–92. DOI: 10.1016/j.ctro.2022.01.001Bakhshandeh M., Hashemi B., Mahdavi S.R. et al. Normal tissue complication probability modeling of radiation-induced hypothyroidism after head-and-neck radiation therapy. Int J Radiat Oncol Biol Phys 2013;85(2):514–21. DOI: 10.1016/j.ijrobp.2012.03.034Denaro N., Merlano M.C., Russi E.G. Follow-up in head and neck cancer: do more does it mean do better? A systematic review and our proposal based on our experience. Clin Exp Otorhinolaryngol 2016;9(4):287–97. DOI: 10.21053/ceo.2015.00976Forastiere A.A., Zhang Q., Weber R.S. et al. Long-term results of RTOG 91–11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 2013;31(7):84552. DOI: 10.1200/JCO.2012.43.6097