title: Time course of hypothalamic-pituitary deficiency in adults receiving cranial radiotherapy for primary extrasellar brain tumors.
abstract: BACKGROUND
  No longitudinal data on hypothalamic-pituitary (HP) function are available in patients who had received cranial radiation therapy (CRT) for primary extrasellar brain tumors (PBT).
  
  
  OBJECTIVE
  To investigate the effects of CRT on HP function in adults with PBT.
  
  
  METHODS
  Twenty-six adults irradiated for PBT and six CRT naive controls were studied. CRT was delivered with 6 MV X-ray by a linear accelerator (2 Gy fraction schedule). Gross Tumor Volume (GTV) excluded the HP region that was contoured on the planning CT. Median dose to the HP region was 41.8 Gy (IQR: 30.7-49.8).
  
  
  RESULTS
  All controls maintained normal HP function. Hypopituitarism developed in 38% of CRT patients (GH deficiency 29%, ACTH 22%, TSH 14%, gonadotropin 4%, no abnormal prolactin level or diabetes insipidus). All HP failures occurred within 32 months after CRT.
  
  
  CONCLUSIONS
  Adults undergoing CRT for PBT are at increased risk for HP dysfunction within 3 years from CRT. Endocrine surveillance is recommended also in adults patients exposed to CRT for primary brain tumors distant from HP region.
authors: Endocrinology Unit, Department of Internal Medicine, San Raffaele Scientific Institute, Milan, Italy.
authors: Sara
authors: S
authors: Madaschi
authors: Madaschi
authors: M
authors: Sara
authors: Claudio
authors: C
authors: Fiorino
authors: Fiorino
authors: F
authors: Claudio
authors: Marco
authors: M
authors: Losa
authors: Losa
authors: L
authors: Marco
authors: Roberto
authors: R
authors: Lanzi
authors: Lanzi
authors: L
authors: Roberto
authors: Elena
authors: E
authors: Mazza
authors: Mazza
authors: M
authors: Elena
authors: Micaela
authors: M
authors: Motta
authors: Motta
authors: M
authors: Micaela
authors: Lucia
authors: L
authors: Perna
authors: Perna
authors: P
authors: Lucia
authors: Elena
authors: E
authors: Brioschi
authors: Brioschi
authors: B
authors: Elena
authors: Marina
authors: M
authors: Scavini
authors: Scavini
authors: S
authors: Marina
authors: Michele
authors: M
authors: Reni
authors: Reni
authors: R
authors: Michele
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000172:deficiency; D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D016371:Cranial Irradiation / Q000009:adverse effects*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006062:Gonadotropins / Q000172:deficiency; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology* / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D018709:Statistics, Nonparametric; D013972:Thyrotropin / Q000172:deficiency; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D006062:Gonadotropins; D019382:Human Growth Hormone; D000324:Adrenocorticotropic Hormone; D013972:Thyrotropin