Summary
Endocrine functions were studied in long-term survivors of low-grade glioma treated with radiotherapy. Hypothalamic-pituitary dysfunction has recently been reported to occur more frequently than generally considered. Because endocrine dysfunction is a treatable condition, careful testing and, if necessary, supplementary treatment may enhance quality of life.
Thirteen adult patients treated with radiotherapy because of supratentorial low-grade glioma at least one year before (range 1–11.5 years) were tested. Focal brain radiotherapy (45–61.2 Gy), with calculated dose to the hypothalamic-pituitary area ranging from 0 to 50 Gy (mean 36.1) had been applied to all patients. Serum levels of pituitary hormones, cortisol and thyroid hormone were determined before and after stimulation with hypothalamic hormones.
In 10 out of 13 patients one or more hormonal values were out of the normal range. Most disturbances were demonstrated in the pituitary-adrenal axis (8 patients) and the GH-axis (4 patients). None of the patients had clinical symptomatology of adrenal, thyroid or gonadal dysfunction. Careful endocrine testing after cranial radiotherapy may reveal (subclinical) hypothalamic-pituitary dysfunction in long-term survivors. Follow-up testing in these patients seems warranted.
Similar content being viewed by others
References
Cairncross JG, Laperriere NJ: Low-grade glioma. To treat or not to treat? Arch Neurol 46: 1238–1239, 1989
Shaw EG: Low-grade gliomas: to treat or not to treat? Arch Neurol 47 1138–1139? 1990
Recht LD, Lew R, Smith TW: Suspected low-grade glioma: is deferring treatment safe? Ann Neurol 31: 431–436, 1992
Shapiro WR: Low-grade gliomas: when to treat? [editorial] Ann Neurol 31: 437–438, 1992
Laws ER, Taylor WF, Clifton MB, Okazaki H: Neurosurgical management of low-grade astrocytoma of the cerebral hemispheres. J Neurosurg 61: 665–673, 1984
Garcia DM, Fulling KH, Marks J: The value of radiation therapy in addition to surgery for astrocytomas of the adult cerebrum. Cancer 55: 919–927, 1985
Morantz RA: Radiation therapy in the treatment of cerebral astrocytoma. Neurosurgery 20: 975–982, 1987
Shaw EG, Daumas-Duport C, Scheithauer BW, Gilbertson DT, O'Fallon JR, Earle JD, Laws ER Jr, Okazaki H: Radiation therapy in the management of low-grade supratentorial astrocytomas. J Neurosurg 70: 853–861, 1989
Gutin PH, Leibel SA, Sheline GE: Radiation injury to the nervous system. Raven Press, New York, 1991
Littley MD, Shalet SM, Beardwell CG: Radiation and the hypothalamic-pituitary axis. In: Gutin PH, Leibel SA, Sheline GE (eds) Radiation injury to the nervous system, Raven Press, New York 303–324, 1991
Constine LS, Woolf PD, Cann D, Mick G, McCormick K, Raubertas RF, Rubin P: Hypothalamic-pituitary dysfunction after radiation for brain tumors. N Engl J Med 328: 87–94, 1993
Bradley JM: Radiotherapy of pituitary tumors. J Coll Rad Aust 9: 36–43, 1965
Tan BC, Kunaratnam N: Hypopituitary dwarfism following radiotherapy for nasopharyngeal carcinoma. Clin Radiol 17: 302–304, 1966
Abayomi OK, Sadeghi-Nejad A: The incidence of late endocrine dysfunction following irradiation for childhood medulloblastoma. Int J Radiat Oncol Biol Phys 12: 945–948, 1986
Rappaport R, Brauner R: Growth and endocrine disorders secondary to cranial irradiation. Pediatr Res 25: 561–567, 1989
Shalet SM: Radiation and pituitary dysfunction [editorial]. N Engl J Med 328: 131–133, 1993
Taphoorn MJB, Heimans JJ, Snoek FJ, Lindeboom J, Oosterink B, Wolbers JG, Karim ABMF: Assessment of quality of life in patients treated for low-grade glioma: a preliminary report. J Neurol Neurosurg Psychiatry 55: 372–376, 1992
Dufour DR, Gaskin JH, Jubiz WA: Dynamic processes in endocrinology. In: Becker KL (ed) Principles and practice of endocrinology and metabolism, Lippincott, Philadelphia 1762–1776, 1990
Perry-Keene DA, Connelly JF, Young RA, Wettenhall HN, Martin FI: Hypothalamic hypopituitarism following external radiotherapy for tumours distant from the adenohypophysis. Clin Endocrinol (Oxf) 5: 373–380, 1976
Duffner PK, Cohen ME, Voorhess ML, MacGillivray MH, Brecher ML, Panahon A, Gilani BB: Long-term effects of cranial irradiation on endocrine function in children with brain tumors: a prospective study. Cancer 56: 2189–2193, 1985
Livesey EA, Brook CGD: Gonadal dysfunction after treatment of intracranial tumours. Arch Dis Child 63: 495–500, 1988
Livesey EA, Brook CGD: Thyroid dysfunction after radiotherapy and chemotherapy of brain tumours. Arch Dis Child 64: 593–595, 1989
Fuks Z, Glatstein E, Marsa GW, Bagshaw MA, Kaplan HS: Long term effects of external radiation on the pituitary and thyroid glands. Cancer 37: 1152–1161, 1976
Wigg DR, Murray RML, Koschel K: Tolerance of the central nervous system to photon irradiation. Endocrine complications. Acta Radiol Oncol 21: 49–60, 1982
DeAngelis LM, Delattre J-Y, Kimmel DW, Posner JB: Radiation-induced dementia in patients cured of brain metastases. Neurology 39: 789–796, 1989
Grossman A, Cohen BL, Charlesworth M: Treatment of prolactinomas with megavoltage radiotherapy. Br Med J 288: 1105–1109, 1984
McGauley GA: Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency. Acta Paediatr Scand (suppl) 356: 70–72, 1989
Degerblad M, Almkvist O, Grunditz R, Hall K, Kaijser L, Knutsson E, Ringertz H, Thoren M: Physical capabilities during substitution therapy with recombinant growth hormone in adults with growth hormone deficiency. Acta Endocrinol 123: 185–193, 1990
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Taphoorn, M.J.B., Heimans, J.J., van der Veen, E.A. et al. Endocrine functions in long-term survivors of low-grade supratentorial glioma treated with radiation therapy. J Neuro-Oncol 25, 97–102 (1995). https://doi.org/10.1007/BF01057753
Issue Date:
DOI: https://doi.org/10.1007/BF01057753