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Article: Symptomatic hypothalamic-pituitary dysfunction in nasopharyngeal carcinoma patients following radiation therapy: A retrospective study

TitleSymptomatic hypothalamic-pituitary dysfunction in nasopharyngeal carcinoma patients following radiation therapy: A retrospective study
Authors
Issue Date1987
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation Oncology - Biology - Physics, 1987, v. 13 n. 9, p. 1343-1350 How to Cite?
AbstractEndocrine assessment was performed in 32 relapse-free southern Chinese patients (21 males and 11 females, aged 27-50 years at the time of assessment) 5-17 years following radiation therapy (RT) alone for early nasopharyngeal carcinoma (NPC). Initial screening was done using questionnaires emphasizing on impaired sexual function and menstrual disturbance plus measurement of serum levels of thyroxine, free thyroxine index, thyrotropic hormone, prolactin, and additionally testosterone for males only. Those showing abnormalities were subjected to detailed pituitary function tests. Hypothalamic-pituitary dysfunction was found in 7 female patients and only 1 male patient. A delayed TSH response to thyrotropin releasing hormone suggesting a hypothalamic disorder was seen in 6 of the affected female patients, and hyperprolactinaemia in also 6. None of the patients had evidence of diabetes insipidus. Hypopituitarism became symptomatic 2-5 years after RT with a mean latent interval of 3.8 years. A practical protocol for regular endocrine assessment for NPC patients after RT has been proposed. Multiple linear regression analysis of the radiotherapeutic data from the 11 female patients indicates that the likelihood of late occurrence of symptomatic hypothalamic-pituitary dysfunction following RT is dependent on the TDF of the target dose to the nasopharyngeal region and the height of the upper margin of the opposed lateral facial fields above the diaphragma sellae (coefficient of multiple correlation = 0.9025). Except when the sphenoid sinus or the middle cranial fossa is involved, it is advisable to set the height of the upper margin of the lateral facial field at a level no higher than the diaphragma sellae. The hypothalamus and possibly the pituitary stalk as well may sustain permanent damage by doses of radiation within the conventional radiotherapeutic range for carcinomas.
Persistent Identifierhttp://hdl.handle.net/10722/161724
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, KSLen_US
dc.contributor.authorHo, JHCen_US
dc.contributor.authorLee, AWMen_US
dc.date.accessioned2012-09-05T05:14:21Z-
dc.date.available2012-09-05T05:14:21Z-
dc.date.issued1987en_US
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 1987, v. 13 n. 9, p. 1343-1350en_US
dc.identifier.issn0360-3016en_US
dc.identifier.urihttp://hdl.handle.net/10722/161724-
dc.description.abstractEndocrine assessment was performed in 32 relapse-free southern Chinese patients (21 males and 11 females, aged 27-50 years at the time of assessment) 5-17 years following radiation therapy (RT) alone for early nasopharyngeal carcinoma (NPC). Initial screening was done using questionnaires emphasizing on impaired sexual function and menstrual disturbance plus measurement of serum levels of thyroxine, free thyroxine index, thyrotropic hormone, prolactin, and additionally testosterone for males only. Those showing abnormalities were subjected to detailed pituitary function tests. Hypothalamic-pituitary dysfunction was found in 7 female patients and only 1 male patient. A delayed TSH response to thyrotropin releasing hormone suggesting a hypothalamic disorder was seen in 6 of the affected female patients, and hyperprolactinaemia in also 6. None of the patients had evidence of diabetes insipidus. Hypopituitarism became symptomatic 2-5 years after RT with a mean latent interval of 3.8 years. A practical protocol for regular endocrine assessment for NPC patients after RT has been proposed. Multiple linear regression analysis of the radiotherapeutic data from the 11 female patients indicates that the likelihood of late occurrence of symptomatic hypothalamic-pituitary dysfunction following RT is dependent on the TDF of the target dose to the nasopharyngeal region and the height of the upper margin of the opposed lateral facial fields above the diaphragma sellae (coefficient of multiple correlation = 0.9025). Except when the sphenoid sinus or the middle cranial fossa is involved, it is advisable to set the height of the upper margin of the lateral facial field at a level no higher than the diaphragma sellae. The hypothalamus and possibly the pituitary stalk as well may sustain permanent damage by doses of radiation within the conventional radiotherapeutic range for carcinomas.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobpen_US
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physicsen_US
dc.subject.meshAdulten_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHypothalamo-Hypophyseal System - Physiopathology - Radiation Effectsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNasopharyngeal Neoplasms - Physiopathology - Radiotherapyen_US
dc.subject.meshRadiotherapy - Adverse Effectsen_US
dc.titleSymptomatic hypothalamic-pituitary dysfunction in nasopharyngeal carcinoma patients following radiation therapy: A retrospective studyen_US
dc.typeArticleen_US
dc.identifier.emailLam, KSL:ksllam@hku.hken_US
dc.identifier.authorityLam, KSL=rp00343en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/0360-3016(87)90227-6-
dc.identifier.pmid3624043-
dc.identifier.scopuseid_2-s2.0-0023194416en_US
dc.identifier.hkuros265774-
dc.identifier.volume13en_US
dc.identifier.issue9en_US
dc.identifier.spage1343en_US
dc.identifier.epage1350en_US
dc.identifier.isiWOS:A1987K011800012-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLam, KSL=8082870600en_US
dc.identifier.scopusauthoridHo, JHC=7402649994en_US
dc.identifier.scopusauthoridLee, AWM=17035384900en_US

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