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Article: Effects of cranial irradiation on hypothalamic-pituitary function - A 5-year longitudinal study in patients with nasopharyngeal carcinoma

TitleEffects of cranial irradiation on hypothalamic-pituitary function - A 5-year longitudinal study in patients with nasopharyngeal carcinoma
Authors
Issue Date1991
Citation
Quarterly Journal Of Medicine, 1991, v. 78 n. 286, p. 165-176 How to Cite?
AbstractThe effects of cranial irradiation on hypothalamic-pituitary function were followed over a 5-year period in 31 adult patients with nasopharyngeal carcinoma. The estimated radiotherapy doses to the hypothalamus and pituitary were 3979 ± 78 (± SD) and 6167 ± 122 cGy, respectively. Within 2 years of radiotherapy, significant impairment in the secretion of growth hormone, gonadotrophins, corticotrophin and thyrotrophin were evident and 14 per cent of patients developed hyperprolactinaemia. Using life table analysis, the cumulative probability of endocrine dysfunction was estimated to be 62 per cent after 5 years with deficiencies in growth hormone, gonadotrophins, corticotrophin and thyrotrophin found in 63.5, 30.7, 26.7 and 14.9 per cent of patients, respectively. Growth hormone deficiency was the earliest endocrine dysfunction observed. Hyperprolactinaemia was uncommon in the male patients but occurred in five of eight women within 3 years of cranial irradiation. The alterations in gonadotrophin secretion suggest a defect in the pulsatile release of gonadotrophin releasing hormone. Twenty-eight patients developed a hypothalamic pattern of delayed thyrotrophin response to thyrotrophin releasing hormone one year after radiotherapy - four subsequently became hypothyroid. Patients who received radiotherapy for cervical lymph nodes were at greater risk of developing hypothyroidism. Thus, in these patients with no pre-existing disease in the hypothalamic-pituitary region, progressive impairment in hypothalamic pituitary function leading to endocrine dysfunction requiring treatment occurs in 50 per cent of patients 5 years after cranial irradiation. Regular endocrine assessment should be performed in all patients following cranial irradiation.
Persistent Identifierhttp://hdl.handle.net/10722/161901
ISSN
1998 Impact Factor: 2.244
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, KSLen_US
dc.contributor.authorTse, VKCen_US
dc.contributor.authorWang, Cen_US
dc.contributor.authorYeung, RTTen_US
dc.contributor.authorHo, JHCen_US
dc.date.accessioned2012-09-05T05:15:55Z-
dc.date.available2012-09-05T05:15:55Z-
dc.date.issued1991en_US
dc.identifier.citationQuarterly Journal Of Medicine, 1991, v. 78 n. 286, p. 165-176en_US
dc.identifier.issn0033-5622en_US
dc.identifier.urihttp://hdl.handle.net/10722/161901-
dc.description.abstractThe effects of cranial irradiation on hypothalamic-pituitary function were followed over a 5-year period in 31 adult patients with nasopharyngeal carcinoma. The estimated radiotherapy doses to the hypothalamus and pituitary were 3979 ± 78 (± SD) and 6167 ± 122 cGy, respectively. Within 2 years of radiotherapy, significant impairment in the secretion of growth hormone, gonadotrophins, corticotrophin and thyrotrophin were evident and 14 per cent of patients developed hyperprolactinaemia. Using life table analysis, the cumulative probability of endocrine dysfunction was estimated to be 62 per cent after 5 years with deficiencies in growth hormone, gonadotrophins, corticotrophin and thyrotrophin found in 63.5, 30.7, 26.7 and 14.9 per cent of patients, respectively. Growth hormone deficiency was the earliest endocrine dysfunction observed. Hyperprolactinaemia was uncommon in the male patients but occurred in five of eight women within 3 years of cranial irradiation. The alterations in gonadotrophin secretion suggest a defect in the pulsatile release of gonadotrophin releasing hormone. Twenty-eight patients developed a hypothalamic pattern of delayed thyrotrophin response to thyrotrophin releasing hormone one year after radiotherapy - four subsequently became hypothyroid. Patients who received radiotherapy for cervical lymph nodes were at greater risk of developing hypothyroidism. Thus, in these patients with no pre-existing disease in the hypothalamic-pituitary region, progressive impairment in hypothalamic pituitary function leading to endocrine dysfunction requiring treatment occurs in 50 per cent of patients 5 years after cranial irradiation. Regular endocrine assessment should be performed in all patients following cranial irradiation.en_US
dc.languageengen_US
dc.relation.ispartofQuarterly Journal of Medicineen_US
dc.subject.meshAdrenocorticotropic Hormone - Deficiencyen_US
dc.subject.meshAdulten_US
dc.subject.meshCranial Irradiation - Adverse Effectsen_US
dc.subject.meshFemaleen_US
dc.subject.meshGonadotropins - Deficiencyen_US
dc.subject.meshGrowth Hormone - Deficiencyen_US
dc.subject.meshHumansen_US
dc.subject.meshHypothalamo-Hypophyseal System - Physiopathology - Radiation Effectsen_US
dc.subject.meshHypothyroidism - Etiologyen_US
dc.subject.meshLongitudinal Studiesen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNasopharyngeal Neoplasms - Radiotherapyen_US
dc.subject.meshRadiation Injuries - Etiologyen_US
dc.subject.meshRadiotherapy - Adverse Effectsen_US
dc.titleEffects of cranial irradiation on hypothalamic-pituitary function - A 5-year longitudinal study in patients with nasopharyngeal carcinomaen_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.pmid1851569en_US
dc.identifier.scopuseid_2-s2.0-0026073199en_US
dc.identifier.volume78en_US
dc.identifier.issue286en_US
dc.identifier.spage165en_US
dc.identifier.epage176en_US
dc.identifier.isiWOS:A1991FB15600008-
dc.identifier.scopusauthoridLam, KSL=8082870600en_US
dc.identifier.scopusauthoridTse, VKC=7003530649en_US
dc.identifier.scopusauthoridWang, C=7501631357en_US
dc.identifier.scopusauthoridYeung, RTT=7102833337en_US
dc.identifier.scopusauthoridHo, JHC=7402649994en_US

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