2013 - Fluoropyrimidines cause hypothyroidism

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2013 - Fluoropyrimidines cause hypothyroidism

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Fujiwara Y, Chayahara N, Mukohara T, Kiyota N, Tomioka H, Funakoshi Y, Minami
H - "Hypothyroidism in patients with colorectal carcinoma treated with
fluoropyrimidines" Oncol Rep 30(4):1802-6 (2013)

Author information:
(1)Division of Internal Medicine and Thoracic Oncology, National Cancer Center
Hospital, Tokyo 104-0045, Japan.

Targeted therapy with tyrosine kinase inhibitors, including vascular endothelial
growth factor receptors, has been demonstrated to induce hypothyroidism and
thyroid dysfunction. Cancer patients with thyroid dysfunction may be
underdiagnosed and undertreated. Thyroid function in colorectal cancer patients
receiving fluoropyrimidine-based chemotherapy with or without bevacizumab was
evaluated at baseline and monthly. In the present study, 3 of 27 (11.1%) patients
who received fluoropyrimidine-based chemotherapy developed a thyroid-stimulating
hormone (TSH) level >10 µU/ml, and 13 (48.1%) developed an elevation above the
upper limit of the normal range. No difference in TSH elevation was noted between
the bevacizumab and chemotherapy-alone group (50 vs. 45%; P=1.00, respectively).
Three (11.1%) patients developed a TSH level >10 µU/ml and 2 with hypothyroidism
were treated with thyroid hormone replacement therapy. We demonstrated that
bevacizumab does not affect thyroid function but fluoropyrimidines may induce
thyroid dysfunction in patients with colorectal cancer. Further investigation is
required to clarify the mechanism of fluoropyrimidine-induced thyroid
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