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1、Riskofhypothyroidismamongpatientswithnasopharyngeal carcinomatreatedwithradiationtherapy: APopulation-BasedCohortStudyJournal:RadiarionandncologyIF：4.36(医学二区)Publication:May201711研究背景及目的2研究方法3研究结果4讨论21、研究背景及目的·Purpose:Thisstudyaimedtoassesstheincidence
2、andriskofhypoth-yroidismamongpatientswithnasopharyngealcarcinoma(NPC)afterradiationtherapy(RT).31、研究背景及目的·Backgroud:①Damagetothehypothalamus-pituitary-thyroidaxismayresultinhypothyroidism,withovertsymptomsincludingweightgain,dryskin,hairloss,coldintole
3、rance,generalweakness,mu-sclecramps,depression,irritability,andmemoryloss.②Asanorgansituatedintheanteriorneck,thethyroidglandisoftenentirelyorpartiallyincludedinthehigh-doseregion.Manyrelatedstudiesonlymphomaandheadandneckcancers(HNC)havereportedthathi
4、gh-doseradiationtothethyroidcaninduceprimaryhypothyroidism.③Radiationinjurytothehypothalamic–pituitary(H–P)axiscanresultindysfunctionoftheH–Paxisfollowedbycentralhypot-hyroidisminNPCpatientsafterRT.4·Backgroud:④Radiation-inducedhypothyroidismafterRTfor
5、NPChasbeenreportedinpreviousstudies.However,therehasbeennonationwideepidemiologicalstudyofNPCpatientsafterRTandthesubsequentriskofhypothyroidismuntilrecently.52、研究方法①Datasource:theNationalHealthInsuranceResearchDatabase(NHIRD).TheNHIRDincludestheRegist
6、ryofCatastrophicIllnessPatientDatabase.②thebaselinecomorbidityhistoryforeachparticipant:hypertension,diabetes,chronicobstructivepulmonarydisease,alcohol-relatedillness,andautoimmunedisease.Cancertreatments：includingchemotherapyandradicalexcisionofcervi
7、callymphnodesamongNPCandHNCcohorts,werealsonoted.6Inclusionandexclusioncriteria:2、研究方法73、研究结果89Therewere213patients(1.43%)thatdevelopedH–PdysfunctionintheNPCcohort,significantlyhigherthanthe56patients(0.35%)intheHNCcohort(p<0.0001).10随着年龄的增加，风险性降低可能原因：
8、城市化程度越高，居民越容易得到医疗资源114、讨论①Inthisstudy,TheriskwassignificantlyhigheramongNPCpatientsafterRTthanamongthematchedcohort(adjustedHR=14.35)andHNCpatientswhoreceivedRTwithoutthyroidectomy(adjustedHR=2.06).②InthemultivariableCoxmodelwithcompeti
