Hormonal dysfunction is frequent in cancer survivors treated with radiotherapy to the head and neck region.
OBJECTIVE
Cancer treatment may lead to hormonal dysfunction. Therefore, we assessed the prevalence of dysfunction in four hormonal axes among long-term cancer survivors who received radiotherapy to the head and neck region and analyzed associations between hormonal status and clinical variables.


METHODS
We included 140 cancer survivors who received radiotherapy to the head and neck region, either locally or through total body irradiation after a diagnosis of lymphoma, plasmacytoma/multiple myeloma, or carcinoma of the epipharynx. Radiation doses to the pituitary gland and thyroid gland were estimated, and blood samples were collected to analyze hormonal levels.


RESULTS
At a median of 16 years after their cancer diagnosis, 46% of cancer survivors showed dysfunction in one hormonal axis, 24% had dysfunction in two axes, and 3% had dysfunction in three axes. Twenty cancer survivors (14%) had hormone levels consistent with pituitary dysfunction. Cancer survivors who had received an estimated 30 Gray (Gy) or more to the pituitary gland had an increased risk for pituitary dysfunction in one of the hormonal axes (odds ratio [OR] 3.16, confidence interval [CI] 1.02-9.87, p = 0.047) and for growth hormone dysfunction alone (OR 2.96, CI 1.02-8.55, p = 0.045).


CONCLUSIONS
Abnormal hormone values are frequent after radiotherapy to the head and neck region.


CONCLUSIONS
Screening for hormonal dysfunction during follow-up might be indicated.
Oslo University Hospital, Oslo, Norway. metse@ous-hf.no.
Mette
M
Seland
Oslo University Hospital, Oslo, Norway.
Trine
T
Bjøro
Oslo University Hospital, Oslo, Norway.
Torbjørn
T
Furre
Oslo University Hospital, Oslo, Norway.
Thomas
T
Schreiner
Oslo University Hospital, Oslo, Norway.
Jens
J
Bollerslev
Oslo University Hospital, Oslo, Norway.
Sophie Dorothea
SD
Fosså
Oslo University Hospital, Oslo, Norway.
Jon Håvard
JH
Loge
Oslo University Hospital, Oslo, Norway.
Harald
H
Holte
Oslo University Hospital, Oslo, Norway.
Cecilie Essholt
CE
Kiserud
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004700:Endocrine System Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000528:radiation effects; D015995:Prevalence; D011832:Radiation Injuries / Q000453:epidemiology*; D011879:Radiotherapy Dosage; D017741:Survivors / Q000706:statistics & numerical data*; D013961:Thyroid Gland / Q000528:radiation effects; D055815:Young Adult
Cancer; Hormonal dysfunction; Late effects; Radiotherapy