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Evaluation of thyroid gland as an organ at risk after breast cancer radiotherapy: a systematic review and meta-analysis

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Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

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.

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Authors and Affiliations

  1. Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

    L. Darvish & N. Roozbeh

  2. Biomedical Engineering and Medical Physics Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    M. Ghorbani

  3. Department of Biostatistics, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran

    S. Hosseini Teshnizi

  4. Department of Radiotherapy and Medical Physics, Faculty of Para medicine, Arak University of Medical Sciences and Khansari Hospital, Arak, Iran

    F. Seif, M. Reza Bayatiani & A. Amraee

  5. Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, USA

    C. Knaup

  6. Department of Medical Physics, Faculty of Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    A. Amraee

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  1. L. Darvish
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  2. M. Ghorbani
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  4. N. Roozbeh
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Correspondence to A. Amraee.

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Darvish, L., Ghorbani, M., Teshnizi, S.H. et al. Evaluation of thyroid gland as an organ at risk after breast cancer radiotherapy: a systematic review and meta-analysis. Clin Transl Oncol 20, 1430–1438 (2018). https://doi.org/10.1007/s12094-018-1875-7

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  • DOI: https://doi.org/10.1007/s12094-018-1875-7

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