Hypothalamic pituitary dysfunction after nasopharyngeal carcinoma irradiation

Area of Science:

• Endocrinology
• Oncology
• Radiation Oncology

Background:

• Radiotherapy (RT) is a primary treatment for nasopharyngeal carcinoma (NPC).
• Late effects of RT, particularly hypothalamic pituitary deficiency (HPD), are a significant concern for NPC survivors.
• Assessing the long-term impact of RT on pituitary function is crucial for patient management.

Purpose of the Study:

• To evaluate the prevalence and characteristics of HPD in nasopharyngeal carcinoma survivors after radiotherapy.
• To identify factors associated with the development of HPD post-RT.

Main Methods:

• A cohort of 55 NPC patients treated with facio-cervical RT was retrospectively analyzed.
• Mean RT dose to the nasopharynx was 73.3 Gy.
• Pituitary function was assessed after a mean follow-up of 9.56 years.

Main Results:

• 61.8% of patients developed HPD.
• Growth hormone (GH) axis deficiency was most common (50.9%), followed by secondary adrenal insufficiency (20%).
• HPD development was not dose-dependent but significantly associated with male gender (OR: 1.67).

Conclusions:

• Hypothalamic pituitary deficiency is a common sequela of RT for NPC.
• Regular pituitary function assessment is recommended for NPC survivors treated with RT.
• Early identification and hormone replacement therapy can improve quality of life.