Thyroid functional disorders caused by radiation therapy to the head and neck
Amergulov I.I., Pavlova M.G., Sych Yu.P., Sotnikov V.M., Kandakova E.Yu., Regentova O.S., Rudneva A.E., Genenko R.V.
Background: Radiation therapy (RT) to the head and neck is a component of treatment for many tumors, including primary central nervous system tumors (PCNST) and some lymphomas. In such cases, the thyroid gland (TG) is within the irradiation field, which can lead to functional impairment.
Objective: Evaluate of thyroid dysfunction in patients after craniospinal irradiation (CSI) and RT to the neck.
Materials and methods: Patients included in the retrospective study were divided into six groups: Group 1 – those who underwent CSI for PCNST before age 18; Group 2 – those who underwent CSI for PCNST at age 18 and later; Group 3 – those who underwent RT to the neck for lymphoma before age 18; Group 4 – those who underwent RT to the neck for lymphoma at age 18 and later; Group 5 – healthy volunteers – a control group for patients irradiated before age 18; Group 6 – healthy volunteers – a control group for patients irradiated at age 18 and later. Thyroid-stimulating hormone (TSH) and free thyroxine (free T4) levels were assessed in all patients.
Results: The incidence of hypothyroidism (HT) after irradiation was higher than in the control groups (OR=11.23, 95% CI 4.14–30.47; p<0.001). Thyrotoxicosis occurred only after irradiation, but these differences were not statistically significant. Younger age increased the risk of developing HT (OR=8.93, 95% CI 3.79–21.05; p<0.001). ROC analysis revealed that the risk of developing HT is highest at the age of 17.5 years and younger (p<0.001). Binary logistic regression analysis also revealed that CSI increases the risk of developing post-radiation HT to a greater extent than RT for lymphomas (p<0.001).
Discussion: The obtained data on the prevalence of HT after RT are consistent with those described in the literature. The risk of HT increases with irradiation at a younger age, and after CSI, the prevalence of HT is higher than after irradiation of the cervical-supraclavicular region for lymphomas.
Conclusion: Thus, RT increases the risk of functional thyroid disorders, especially HT. Younger age at irradiation, as well as CSI, increase the risk of developing HT.
For citations: Amergulov I.I., Pavlova M.G., Sych Yu.P., Sotnikov V.M., Kandakova E.Yu., Regentova O.S., Rudneva A.E., Genenko R.V. Thyroid functional disorders caused by radiation therapy to the head and neck. Pharmateca. 2026;33(2):90-98. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.2.90-98
Authors’ contribution: I.I. Amergulov, M.G. Pavlova, Yu.P. Sych – study design, analysis of the obtained results, writing the final version of the article. R.V. Genenko – patient examination, participation in the analysis of the obtained results, writing part of the final version of the article. V.M. Sotnikov, E.Yu. Kandakova, O.S. Regentova, A.E. Rudneva – information on the patients’ medical history, significant contribution to the writing of the article. All authors approved the final version of the article.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Ethical Approval: The study was approved by the Local Ethics Committee of the I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), extract from protocol No. 02-23 dated January 26, 2023.
Patient Consent for Publication: The retrospective design of the study did not require informed consent from patients for statistical processing of anonymized data for subsequent publication.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
Keywords
hypothyroidism
thyrotoxicosis
craniospinal irradiation
radiation therapy
lymphoma
medulloblastoma
About the Authors
I.I. Amergulov, Postgraduate Student, Department of Endocrinology and Metabolic Health, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; ilya_a94@mail.ru, ORCID https://orcid.org/0000-0001-8637-1483 (corresponding author)M.G. Pavlova, Cand. Sci. (Med.), Associate Professor, Department of Endocrinology and Metabolic Health, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; mgp.doc@yandex.ru, ORCID: https://orcid.org/0000-0001-6073-328X
Yu.P. Sych, Cand. Sci. (Med.), Associate Professor, Department of Endocrinology and Metabolic Health, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; juliasytch@mail.ru, ORCID: https://orcid.org/0000-0002-7000-0095
V.M. Sotnikov, Dr. Sci. (Med.), Professor, Head of the MASC, Russian Research Center of Roentgenology and Radiology, Moscow, Russia; ORCID: https://orcid.org/0000-0003-0498-314X
E.Yu. Kandakova, Dr. Sci. (Med.), Head of the 70-Bed Radiation Therapy Department with a 30-Bed Day Hospital of the Radiation Therapy Clinic, Russian Research Center of Roentgenology and Radiology, Moscow, Russia; ORCID: https://orcid.org/0000-0001-7127-7881
O.S. Regentova, Dr. Sci. (Med.), Head of the Department of Radiation Therapy for Children with Oncology Beds, Russian Research Center of Roentgenology and Radiology, Moscow, Russia; ORCID: https://orcid.org/0000-0002-0219-7260
A.E. Rudneva, Senior Researcher, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia; anastasija.rudneva@fccho-moscowdgoi.ru, ORCID: https://orcid.org/0000-0001-6628-0760
R.V. Genenko, Resident, Department of Endocrinology and Metabolic Health, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; dreikpaim@mail.ru, ORCID: https://orcid.org/0009-0006-9887-484X
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