title: Pituitary dysfunction in adult patients after cranial irradiation for head and nasopharyngeal tumours.
abstract: BACKGROUND
  Pituitary insufficiency after radiotherapy in the hypothalamic pituitary region is a well-known complication. However, endocrine assessments are not incorporated in the follow-up after cranial irradiation for head and neck tumours.
  
  
  OBJECTIVE
  To evaluate pituitary function in patients cranially irradiated for non-pituitary tumours.
  
  
  METHODS
  Evaluation of pituitary function in all available patients treated at our centre with cranial radiotherapy for head and neck tumours.
  
  
  RESULTS
  We included 80 patients. Forty patients were treated for cerebral tumours, 15 for nasopharyngeal tumours, and 25 for different tumours like meningioma or cerebral metastasis. Mean age was 47.5 (18.6-89.7)years. Mean radiation dose delivered at the pituitary region was 56.27 Gy (40.0-70.0). Pituitary insufficiency was present in 16 patients within 2 years after irradiation 23/49 patients (47%) after 5 years and 27/45 (60%) after 10 years and 31/35 patients (89%) after 15 years.
  
  
  CONCLUSIONS
  Pituitary insufficiency is highly prevalent in adult patients treated with cranial radiotherapy for head and nasopharyngeal tumours. These prevalence rates are comparable to those observed after radiotherapy for pituitary tumours. Because hormone replacement of endocrine deficits improves quality of life and prevents potential severe complications, such as Addisonian crises, periodical evaluation of pituitary function is advocated.
authors.affiliation: Center for Endocrine Tumours Leiden, Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, The Netherlands. Electronic address: n.m.appelman-dijkstra@lumc.nl.
authors.forename: Natasha M
authors.initials: NM
authors.lastname: Appelman-Dijkstra
authors.affiliation: Center for Endocrine Tumours Leiden, Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Malgo
authors.affiliation: Department of Clinical Oncology & Radiotherapy, Leiden University Medical Center, The Netherlands.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Neelis
authors.affiliation: Department of Clinical Oncology & Radiotherapy, Leiden University Medical Center, The Netherlands.
authors.forename: Ida
authors.initials: I
authors.lastname: Coremans
authors.affiliation: Center for Endocrine Tumours Leiden, Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, The Netherlands.
authors.forename: Nienke R
authors.initials: NR
authors.lastname: Biermasz
authors.affiliation: Center for Endocrine Tumours Leiden, Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, The Netherlands.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007006:Hypogonadism / Q000209:etiology; D007018:Hypopituitarism / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy; D010902:Pituitary Gland / Q000528:radiation effects; D011788:Quality of Life; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cerebral tumours; Follow up; Nasopharyngeal carcinoma; Pituitary insufficiency; Radiotherapy