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Nine patients(28 percent)had symptoms of thyroid deficiency,and 20 patients(62 percent)had low serum total or free thyroxine or total triiodothyronine concentrations.Of the 23 patients treated only with cranial radiation,15(65 percent)had hypothalamic or pituitary hypothyroidism.Of the nine patients who also received spinal(and thus direct thyroid)radiation,three(33 percent)had evidence of primary thyroid injury.Seven of the 10 postpubertal,premenopausal women(70 percent)had oligomenorrhea,and 5(50 percent)had low serum estradiol concentrations. Three of the 10 men(30 percent)had low serum testosterone concentrations. Overall,14 of the 23 postpubertal patients(61 percent)had evidence of hypogonadism.Mild hyperprolactinemia was present in 50 percent of the patients.Responses to stimulation with corticotropin-releasing hormone and corticotropin were normal in all patients except one,who had panhypothalamic dysfunction.However,serum 11-deoxycortisol responses to the administration of metyrapone were low in 11 of the 31 patients(35 percent)tested.Three of the 32 patients(9 percent)had no endocrine abnormalities,9(28 percent)had an abnormal result on tests of thyroid, gonadal,prolactin,or adrenal function,8(25 percent)had abnormalities in two axes,8(25 percent)in three axes,and 4(12 percent)in all four axes. Conclusions.Cranial radiotherapy in children and adults with brain tumors frequently causes abnormal hypothalamic-pituitary function.The most frequent changes are hypothyroidism and gonadal dysfunction,although subtle abnormalities in adrenal function may also be present. |
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growth hormone
hypogonadism
hypopituitarism
hypothalamus
hypothalamus,damage to
hypothalamus,disturbance of
hypothyroidism
iatrogenic neurologic disorders
menses,irregular
neuroendocrinology
oligomenorrhea
pituitary,hormones of
prolactin,elevated
radiation therapy,CNS treatment and complications with
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