Pituitary dysfunction in adult patients after cranial irradiation for head and nasopharyngeal tumours

Abstract

BackgroundPituitary insufficiency after radiotherapy in the hypothalamic pituitary region is a well-known complication. However, endocrine assessments are not incorporated in the follow-up after cranial irradiation for head and neck tumours. Aim of the studyTo evaluate pituitary function in patients cranially irradiated for non-pituitary tumours. Patients and methodsEvaluation of pituitary function in all available patients treated at our centre with cranial radiotherapy for head and neck tumours. ResultsWe included 80 patients. Forty patients were treated for cerebral tumours, 15 for nasopharyngeal tumours, and 25 for different tumours like meningioma or cerebral metastasis. Mean age was 47.5 (18.6–89.7)years. Mean radiation dose delivered at the pituitary region was 56.27Gy (40.0–70.0). Pituitary insufficiency was present in 16 patients within 2years after irradiation 23/49 patients (47%) after 5years and 27/45 (60%) after 10years and 31/35 patients (89%) after 15years. ConclusionPituitary insufficiency is highly prevalent in adult patients treated with cranial radiotherapy for head and nasopharyngeal tumours. These prevalence rates are comparable to those observed after radiotherapy for pituitary tumours. Because hormone replacement of endocrine deficits improves quality of life and prevents potential severe complications, such as Addisonian crises, periodical evaluation of pituitary function is advocated.