{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:48:51Z","timestamp":1785286131329,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2019,9,27]],"date-time":"2019-09-27T00:00:00Z","timestamp":1569542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2017A030312003"],"award-info":[{"award-number":["2017A030312003"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81572962"],"award-info":[{"award-number":["81572962"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To identify thyroid dose\u2010volume thresholds for radiotherapy (RT)\u2010related hypothyroidism (HT) in patients with nasopharyngeal carcinoma (NPC) treated with intensity\u2010modulated RT (IMRT). In this way, we desired to guide the design of treatment plans and, finally, lower HT prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 345 NPC patients treated with IMRT were evaluated retrospectively during a median follow\u2010up of 45.2 (range, 11.3\u201064.9) months. Serum\u2010based assessments of thyroid function before and after IMRT were monitored periodically. Thyroid dose\u2010volume parameters were analyzed for their association with HT risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 44.1% of patients (152\/345) developed primary HT. Analyses of thyroid dose\u2010volume parameters identified a stringent dose\u2010volume histogram (DVH) threshold defined by <jats:italic>V<\/jats:italic><jats:sub>25Gy<\/jats:sub> (the percentage thyroid volume that receives &gt;25\u00a0Gy, not the absolute volume) \u226460%, <jats:italic>V<\/jats:italic><jats:sub>35Gy<\/jats:sub>\u00a0\u2264\u00a055%, and <jats:italic>V<\/jats:italic><jats:sub>45Gy<\/jats:sub>\u00a0\u2264\u00a045%. Patients whose thyroid DVHs satisfied these constraints had a lower prevalence of 2\u2010year HT compared with the overall prevalence (13.2% vs 25.8%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Another DVH was defined by <jats:italic>V<\/jats:italic><jats:sub>25Gy<\/jats:sub>\u00a0&gt;\u00a095%, <jats:italic>V<\/jats:italic><jats:sub>35Gy<\/jats:sub>\u00a0&gt;\u00a090%, and <jats:italic>V<\/jats:italic><jats:sub>45Gy<\/jats:sub>\u00a0&gt;\u00a075%, and patients whose thyroid DVHs satisfied with these constraints had a higher prevalence of 2\u2010year HT than the overall incidence (36.0% vs 25.8%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We recommend <jats:italic>V<\/jats:italic><jats:sub>25Gy<\/jats:sub>\u00a0\u2264\u00a060%, <jats:italic>V<\/jats:italic><jats:sub>35Gy<\/jats:sub>\u00a0\u2264\u00a055%, and <jats:italic>V<\/jats:italic><jats:sub>45Gy<\/jats:sub>\u00a0\u2264\u00a045% as the \u201cstringent\u201d DVH line, and <jats:italic>V<\/jats:italic><jats:sub>25Gy<\/jats:sub>\u00a0&gt;\u00a095%, <jats:italic>V<\/jats:italic><jats:sub>35Gy<\/jats:sub>\u00a0&gt;\u00a090%, and <jats:italic>V<\/jats:italic><jats:sub>45Gy<\/jats:sub>\u00a0&gt;\u00a075% as the \u201cinhibition\u201d DVH line, under the precondition of not compromising the target coverage. These findings could help in the design of individual treatment plans and, eventually, to lowering of HT prevalence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.2574","type":"journal-article","created":{"date-parts":[[2019,9,27]],"date-time":"2019-09-27T17:06:27Z","timestamp":1569603987000},"page":"6887-6893","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Thyroid dose\u2010volume thresholds for the risk of radiation\u2010related hypothyroidism in nasopharyngeal carcinoma treated with intensity\u2010modulated radiotherapy\u2014A single\u2010institution study"],"prefix":"10.1002","volume":"8","author":[{"given":"Cheng\u2010Long","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma 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