부산의대 / 박종무, 주지현*
Abstract
This Korean population-based study aimed to describe the patterns of hypothyroidism after adjuvant radiation therapy (RT) in patients with breast cancer. The Korean Health Insurance Review and Assessment Service database was searched for patients with invasive breast carcinomas. We calculated the cumulative incidence and incidence rates per 1,000 person-years of subsequent hypothyroidism and compared them using the log-rank test and the Cox proportional hazards model. Between 2007 and 2018, 117,135 women diagnosed with breast cancer with a median follow-up time of 4.6 years were identified. The 8-year incidence of hypothyroidism was 9.3% in patients treated with radiation and 8.6% in those treated without radiation (p = 0.002). The incidence rates per 1,000 person-years in the corresponding treatment groups were 6.2 and 5.7 cases, respectively. The hazard ratio (HR) in patients receiving RT was 1.081 (95% confidence interval [CI], 1.013-1.134; p = 0.002). After mastectomy, RT showed a trend toward a higher risk of hypothyroidism (HR = 1.248; 95% CI, 0.977-1.595; p = 0.076). Our study provides one of the largest population-based data analyses regarding the risk of hypothyroidism among Korean patients with breast cancer. The adjusted risk for patients treated with RT exceeded that for patients with breast cancer treated without RT. The effect was evident immediately after treatment and lasted up to approximately 9 years.
Affiliations
Jongmoo Park 1 , Choongrak Kim 2 , Yongkan Ki 3 4 , Wontaek Kim 3 5 , Jiho Nam 5 , Donghyun Kim 3 5 , Dahl Park 5 , Hosang Jeon 4 , Dong Woon Kim 4 , Ji Hyeon Joo 3 4
1 Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Korea.
2 Department of Statistics, Pusan National University, Busan, Korea.
3 Department of Radiation Oncology, Pusan National University School of Medicine, Yangsan, Korea.
4 Department of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan, Korea.
5 Department of Radiation Oncology, Pusan National University Hospital, Busan, Korea.
편집위원
심평원 자료를 이용하여 유방암 방사선치료 후 갑상선기능저하증의 빈도를 분석한 논문으로, 방사선치료를 받은 경우 HR가 1.081로 통계적으로 유의한 상관관계를 보였음
2022-08-02 13:03:42
편집위원2
유방암환자에서 방사선치료 후 갑상선기능저하증이 발생할 위험성이 시간이 경과함에 따라 계속 증가하는 것을 보여준 흥미로운 연구로 건강보험 자료 특성상 RT dose, field, systemic Tx 연관성 등은 추가 연구가 필요합니다.
2022-08-02 14:22:13