title: Thyroid size change by CT monitoring after sorafenib or sunitinib treatment in patients with renal cell carcinoma: comparison with thyroid function.
abstract: OBJECTIVE
  Hypothyroidism is a common complication in patients receiving tyrosine kinase inhibitors. We evaluated the relationship between thyroid size evident on CT and thyroid function in patients with advanced renal cell carcinoma (RCC) receiving tyrosine kinase inhibitors.
  
  
  METHODS
  Forty-two patients with metastatic RCC receiving tyrosine kinase inhibitors (sorafenib n=25; sunitinib n=17) and, followed-up for ≥12 months were eligible. Patients who had ever shown an elevated thyroid-stimulating hormone (TSH) level of >10 mU/l were defined as having "hypothyroidism". CT scans were performed before, and 3, 6, 9, and 12 months after the start of treatment. The area of the thyroid in the maximum section at each examination was measured and compared with that before treatment. Using repeated-measures ANOVA, differences in thyroid size were compared over time between patients with and without "hypothyroidism", in relation to the type of drug employed.
  
  
  RESULTS
  Twenty-one patients (sorafenib 9, sunitinib 12) developed "hypothyroidism" 95±88 days (range 12-315 days) after the start of treatment. In such patients, the thyroid was reduced in size to 89±16% after 3 months, 81±21% after 6 months, 71±21% after 9 months and 68±21% after 12 months, whereas the patients without "hypothyroidism" maintained a thyroid size of 90±12% even after 12 months (p=0.0030). Among the patients with "hypothyroidism", those treated with sunitinib tended to show greater thyroid size reduction than those with sorafenib (59±23% vs. 79±13%, after 12 months).
  
  
  CONCLUSIONS
  Tyrosine kinase inhibitors cause an apparent thyroid size reduction in patients with "hypothyroidism".
authors: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. kitajima@med.kobe-u.ac.jp
authors: Kazuhiro
authors: K
authors: Kitajima
authors: Satoru
authors: S
authors: Takahashi
authors: Tetsuo
authors: T
authors: Maeda
authors: Takeshi
authors: T
authors: Yoshikawa
authors: Yoshiharu
authors: Y
authors: Ohno
authors: Masahiko
authors: M
authors: Fujii
authors: Hideaki
authors: H
authors: Miyake
authors: Masato
authors: M
authors: Fujisawa
authors: Kazuro
authors: K
authors: Sugimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000009:adverse effects* / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced* / Q000000981:diagnostic imaging; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D009929:Organ Size / Q000187:drug effects; D010671:Phenylurea Compounds; D011725:Pyridines / Q000009:adverse effects* / Q000627:therapeutic use; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use; D000077157:Sorafenib; D000077210:Sunitinib; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000187:drug effects*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D007211:Indoles; D010671:Phenylurea Compounds; D011725:Pyridines; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib