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Long-term anterior pituitary function in patients with paediatric Cushing's disease treated with pituitary

L F Chan1, H L Storr, P N Plowman

  • 1Departments of Endocrinology, St Bartholomew's and The Royal London School of Medicine and Dentistry, London, UK.

European Journal of Endocrinology
|March 29, 2007
PubMed

Insights

Long-term pituitary function in children treated for Cushing's disease with radiotherapy (RT) shows growth hormone deficiency may resolve. Continued surveillance is essential for pediatric patients receiving RT.

Area of Science:

  • Pediatric Endocrinology
  • Radiation Oncology
  • Endocrine Surgery

Background:

  • Cushing's disease (CD) in children often requires second-line treatment.
  • Pituitary radiotherapy (RT) is an effective option for pediatric CD after surgery.
  • Long-term effects of pituitary RT on pediatric endocrine function require further investigation.

Purpose of the Study:

  • To evaluate long-term anterior pituitary function in pediatric Cushing's disease patients treated with pituitary RT.
  • To assess the sequelae of pituitary RT in a cohort of young patients.

Main Methods:

  • Retrospective analysis of 12 pediatric CD patients treated with pituitary RT (45 Gy).
  • Patients received RT between 1983-2006 following unsuccessful transsphenoidal surgery.
  • Long-term data focused on six male patients with a mean follow-up of 10.5 years post-RT.

Main Results:

  • Growth hormone (GH) deficiency was observed in 5/6 patients at 1 year post-RT.
  • GH sufficiency was regained in 3/4 patients by a mean of 9.3 years after RT.
  • Other anterior pituitary functions and testicular volumes remained normal in the long-term follow-up.

Conclusions:

  • Pituitary radiotherapy in pediatric Cushing's disease does not appear to cause serious long-term pituitary deficiencies.
  • The study highlights the potential for recovery of endocrine function, particularly GH.
  • Emphasizes the critical need for ongoing surveillance of pituitary function in these patients.
Abstract

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