Endocrine morbidity in adults treated with cerebral irradiation for brain tumours during childhood.
Hypothalamic-pituitary function was assessed in 20 adult subjects who were treated with cerebral irradiation for brain tumours during childhood between 8 and 32 years earlier. Nine patients showed impaired growth hormone (GH) responses to hypoglycaemia, of whom, 7 are below the third centile for standing height. All GH deficient subjects received more than 2950 rads to the hypothalamic-pituitary axis with a maximum dose of approximately 5000 rads being used in one case. Three subjects have an elevated basal serum thyroid stimulating hormone (TSH) level and 2 of these show an exaggerated TSH response to thyrotrophin releasing hormone (TRH) but no patient was clinically or biochemically hypothyroid. The rest of hypothalamic-pituitary function was essentially normal. This study shows that multiple pituitary hormone deficiencies do no develop with time when the radiation dose is below a critical level. Thus it appears that there is a gradation of radiation damage to the hypothalamic-pituitary axis which is dependent primarily on the dose received rather than the time interval after radiotherapy.
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001827:Body Height; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002648:Child; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D013006:Growth Hormone / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007031:Hypothalamus / Q000528:radiation effects*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008572:Menarche; D010900:Pituitary Diseases / Q000209:etiology*; D010902:Pituitary Gland / Q000528:radiation effects*; D010903:Pituitary Gland, Anterior / Q000378:metabolism; D010907:Pituitary Hormones / Q000378:metabolism*; D011388:Prolactin / Q000097:blood; D011832:Radiation Injuries; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood
D001786:Blood Glucose; D010907:Pituitary Hormones; D014284:Triiodothyronine; D013739:Testosterone; D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin; D013006:Growth Hormone; D013974:Thyroxine; D006854:Hydrocortisone