Radiation-induced hypopituitarism in patients with nasopharyngeal carcinoma

Abstract

Objective To investigate the clinical characteristics and imaging features of radiation-induced hypopituitarism (RIH) in nasopharyngeal carcinoma (NPC) patients after radiotherapy.Methods Retrospective study was performed on the clinical data of 9 NPC patients (7 males and 2 females), diagnosed as RIH after radiotherapy in our hospital from 2000 to 2009; their clinical manifestations, anterior-pituitary hormone levels, cranial MRI features and follow-up results were analyzed. Results The interval between complications after radiotherapy and diagnoses of RIH varied from 10 months to 15 years.Multiple hormone deficits appeared in 5 patients; thyrotropin deficiency and hyperprolactinemia were the most common complications, followed by adrenocorticotropic hormone (ACTH) insufficiency.Typical radiological imaging of the pituitary gland displayed partially empty sella and atrophy of pituitaly gland,which was demonstrated in 2 patients.Five patients got improvement after hormone replacement therapy. Conclusion Radiation-induced hypopituitarism may occur in NPC patients; most patients are subclinical without typical radiological alterations in MRI for pituitary.Routine evaluation of adenohypophysis function is necessary for early detection of hormone deficiency and early hormone replacement treatment. Key words: Hypopituitarism; Nasopharyngeal carcinoma; Adenohypophysis hormone; Radiotherpy