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Hypothalamic-Pituitary Axis Dysfunction after Whole Brain Radiotherapy - A Cohort Study.

Judith Gebauer1, Preena Mehta2, Fabian B Fahlbusch3

  • 1Institute for Endocrinology and Diabetes, University of Luebeck, Luebeck, Germany.

Anticancer Research
|September 29, 2020
PubMed
Summary

Hypothalamic-pituitary (HT-P) dysfunction is common in adult cancer survivors after whole brain radiotherapy (WBRT). Routine endocrine check-ups are crucial for early detection of HT-P axis impairment following WBRT.

Keywords:
Whole brain radiotherapycancer survivorendocrine late effectshypothalamic-pituitary dysfunction

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiation Oncology

Background:

  • Cranial radiotherapy, particularly whole brain radiotherapy (WBRT), is associated with endocrine late effects.
  • Hypothalamic-pituitary (HT-P) dysfunction is a known complication, but data in adult-onset cancer patients post-WBRT are limited.

Purpose of the Study:

  • To determine the prevalence of HT-P axis dysfunction in adult cancer patients treated with WBRT.
  • To identify the incidence of single or multiple endocrine axis impairments.

Main Methods:

  • A cohort of 26 adult cancer patients previously treated with WBRT underwent standardized endocrine evaluations.
  • Follow-up duration was a median of 20.5 months, focusing on HT-P function.

Main Results:

  • 50% of patients exhibited impaired HT-P function during follow-up.
  • 34.6% had single hormonal axis loss, 7.7% had multiple axis impairment, and one patient developed adrenocorticotropic hormone deficiency.
  • No direct correlation was found between WBRT total dose and HT-P dysfunction.

Conclusions:

  • Hypothalamic-pituitary dysfunction is a frequent complication after WBRT in adult cancer patients.
  • Dysfunction can be diagnosed as early as 6 months post-radiation.
  • Routine endocrine follow-up is recommended for these patients, irrespective of life expectancy.