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Radiotherapy-induced hypopituitarism: a review

Radiotherapy-induced hypopituitarism: a review Hypopituitarism is a disorder caused by impaired hormonal secretions from the hypothalamic–pituitary axis. Radiotherapy is the most common cause of iatrogenic hypopituitarism. The hypothalamic–pituitary axis inadvertently gets irradiated in patients receiving prophylactic cranial radiotherapy for leukemia, total body irradiation and radiotherapy for intracranial, base skull, sinonasal and nasopharyngeal tumors. Radiation-induced hypopituitarism (RIH) is insidious, progressive and largely nonreversible. Mostly, RIH involves one hypothalamic–pituitary axis; however, multiple hormonal axes deficiency starts developing at higher doses. Although the clinical effects of the hypopituitarism are more profound in children and young adults, its implications in older adults are being increasingly recognized. The risk continues to persist or increase up to 10 years following radiation exposure. The clinical management of hypopituitarism is challenging both for the patients and healthcare providers. Here we have reviewed the scale of the problem, the risk factors and the management of RIH. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Expert Review of Anticancer Therapy Taylor & Francis

Radiotherapy-induced hypopituitarism: a review

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References (113)

Publisher
Taylor & Francis
Copyright
© Expert Reviews Ltd
ISSN
1744-8328
eISSN
1473-7140
DOI
10.1586/era.12.27
pmid
22594901
Publisher site
See Article on Publisher Site

Abstract

Hypopituitarism is a disorder caused by impaired hormonal secretions from the hypothalamic–pituitary axis. Radiotherapy is the most common cause of iatrogenic hypopituitarism. The hypothalamic–pituitary axis inadvertently gets irradiated in patients receiving prophylactic cranial radiotherapy for leukemia, total body irradiation and radiotherapy for intracranial, base skull, sinonasal and nasopharyngeal tumors. Radiation-induced hypopituitarism (RIH) is insidious, progressive and largely nonreversible. Mostly, RIH involves one hypothalamic–pituitary axis; however, multiple hormonal axes deficiency starts developing at higher doses. Although the clinical effects of the hypopituitarism are more profound in children and young adults, its implications in older adults are being increasingly recognized. The risk continues to persist or increase up to 10 years following radiation exposure. The clinical management of hypopituitarism is challenging both for the patients and healthcare providers. Here we have reviewed the scale of the problem, the risk factors and the management of RIH.

Journal

Expert Review of Anticancer TherapyTaylor & Francis

Published: May 1, 2012

Keywords: cancer survivors; hypopituitarism; late effect; nasopharyngeal cancer; neuroendocrinopathy; pituitary; pituitary dysfunction; radiotherapy; skull base tumors; toxicity

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