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Related Experiment Videos

Radiation-induced hypopituitarism is dose-dependent.

M D Littley1, S M Shalet, C G Beardwell

  • 1Department of Endocrinology, Christie Hospital and Holt Radium Institute, Withington, Manchester, UK.

Clinical Endocrinology
|September 1, 1989
PubMed
Summary

Radiation therapy can cause hormone deficiencies. Higher radiation doses and certain fractionation schedules increase the risk of TSH, ACTH, gonadotrophin, and growth hormone deficiencies in patients with pituitary disease.

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Area of Science:

  • Endocrinology
  • Radiation Oncology
  • Oncology

Background:

  • Radiation-induced hypopituitarism is a significant concern in patients treated for pituitary disease and other intracranial neoplasms.
  • Prospective studies are crucial to understand the long-term effects of radiotherapy on pituitary function.

Purpose of the Study:

  • To investigate the incidence and dose-response relationship of radiation-induced pituitary hormone deficiencies.
  • To evaluate the impact of radiation dose and fractionation on the development of hypopituitarism.

Main Methods:

  • Prospective study of 251 adult patients treated with external radiotherapy for pituitary disease (20-45 Gy).
  • Analysis of 10 patients post-whole-body irradiation (12 Gy) for hematological malignancies.
  • Assessment of 7 patients post-whole-brain radiotherapy (30 Gy) for brain tumors.

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  • Hormone level assessment over time post-treatment.

    • Main Results:

    • Significant increase in TSH deficiency with increasing radiation dose (9% at 20 Gy to 52% at 42-45 Gy).
    • Similar dose-dependent increases observed for ACTH and gonadotrophin deficiencies.
    • Universal growth hormone deficiency by 5 years for doses of 35-45 Gy.
    • No pituitary dysfunction detected after 12 Gy whole-body irradiation.

    Conclusions:

    • Both total radiation dose and fractionation schedule influence the incidence of pituitary hormone deficiencies.
    • A threshold dose below which deficiencies do not occur may exist but is likely irrelevant for therapeutic irradiation.
    • Findings highlight the importance of dose and fractionation in managing risks of hypopituitarism.