{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:38:24Z","timestamp":1754145504664,"version":"3.41.2"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["303068\/2021\u20103"],"award-info":[{"award-number":["303068\/2021\u20103"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To evaluate thyroid dysfunction(TD) among patients with head and neck squamous cell carcinoma (HNSCC) submitted to external radiotherapy (RT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study focused on early and long\u2010term TD in 285 HNSCC patients treated with RT alone or combined with radiochemotherapy and\/or surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 156 (54.7%) patients presented TD during follow\u2010up, 153 (53.7%) TD in long\u2010term. Subclinical hypothyroidism (SCH) was the TD first identified in 43.5%; persisted in 68.5%, evolved to overt hypothyroidism in 21%, central hypothyroidism in 0.8%, returned to euthyroidism in 9.7%. TD first detection was 7.2\u2009months after RT, 3.85\u2009months for subclinical thyrotoxicosis, 17.77\u2009months for SCH. Type 2 diabetes mellitus (DM2), metastatic lymph nodes, no tumor resection were TD risk factors. All patients with TSH\u2009\u2265\u20097.5\u2009mIU\/mL developed primary\/SCH, 19.5% with TSH\u2009&lt;\u20097.5\u2009mIU\/mL remained euthyroid at long\u2010term follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Frequent monitoring of thyroid function is necessary in patients with HNSCC after RT, particularly with DM2, lymph node involvement, no surgical tumor resection.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.28150","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T22:09:32Z","timestamp":1743718172000},"page":"2336-2347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early and Long\u2010Term Thyroid Dysfunction in Patients With Head and Neck Squamous Cell Carcinoma After External Radiotherapy: Clinicopathological Risk Factors"],"prefix":"10.1002","volume":"47","author":[{"given":"Adriana Russo","family":"Fiore","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medical Sciences, Endocrinology Division University of Campinas  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo Jacob","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Laboratory of Cancer Genetics, School of Medical Sciences University of Campinas  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo Baldon","family":"Pereira","sequence":"additional","affiliation":[{"name":"Radiotherapy Division, School of Medical Sciences University of Campinas  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana Freire De Almeida","family":"dos Anjos","sequence":"additional","affiliation":[{"name":"Clinical Oncology Division, School of Medical Sciences University of Campinas  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen Silvia Passos","family":"Lima","sequence":"additional","affiliation":[{"name":"Laboratory of Cancer Genetics, School of Medical Sciences University of Campinas  S\u00e3o Paulo Brazil"},{"name":"Clinical Oncology Division, School of Medical Sciences University of Campinas  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7434-5701","authenticated-orcid":false,"given":"Denise Engelbrecht","family":"Zantut\u2010Wittmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medical Sciences, Endocrinology Division University of Campinas  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2015.00976"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0229"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3857\/roj.2020.00213"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/jcrt.JCRT_148_19"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010019\u201002023\u20107"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.32170"},{"key":"e_1_2_11_10_1","first-page":"1529","volume-title":"Werner & Ingbar's the Thyroid: A Fundamental and Clinical Text","author":"Ladenson P. 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