Seland Mette, Bjøro Trine, Furre Torbjørn, Schreiner Thomas, Bollerslev Jens, Fosså Sophie Dorothea, Loge Jon Håvard, Holte Harald, Kiserud Cecilie Essholt
Oslo University Hospital, Oslo, Norway.
J Cancer Surviv. 2015 Dec;9(4):630-40. doi: 10.1007/s11764-015-0439-x. Epub 2015 Mar 7.
Cancer treatment may lead to hormonal dysfunction. Therefore, we assessed the prevalence of dysfunction in four hormonal axes among long-term cancer survivors who received radiotherapy to the head and neck region and analyzed associations between hormonal status and clinical variables.
We included 140 cancer survivors who received radiotherapy to the head and neck region, either locally or through total body irradiation after a diagnosis of lymphoma, plasmacytoma/multiple myeloma, or carcinoma of the epipharynx. Radiation doses to the pituitary gland and thyroid gland were estimated, and blood samples were collected to analyze hormonal levels.
At a median of 16 years after their cancer diagnosis, 46% of cancer survivors showed dysfunction in one hormonal axis, 24% had dysfunction in two axes, and 3% had dysfunction in three axes. Twenty cancer survivors (14%) had hormone levels consistent with pituitary dysfunction. Cancer survivors who had received an estimated 30 Gray (Gy) or more to the pituitary gland had an increased risk for pituitary dysfunction in one of the hormonal axes (odds ratio [OR] 3.16, confidence interval [CI] 1.02-9.87, p = 0.047) and for growth hormone dysfunction alone (OR 2.96, CI 1.02-8.55, p = 0.045).
Abnormal hormone values are frequent after radiotherapy to the head and neck region.
Screening for hormonal dysfunction during follow-up might be indicated.
癌症治疗可能导致激素功能障碍。因此，我们评估了接受头颈部放疗的长期癌症幸存者中四个激素轴功能障碍的患病率，并分析了激素状态与临床变量之间的关联。
我们纳入了140名头颈部接受放疗的癌症幸存者，这些患者在被诊断为淋巴瘤、浆细胞瘤/多发性骨髓瘤或下咽癌后，接受了局部或全身照射。估计垂体和甲状腺的辐射剂量，并采集血样分析激素水平。
在癌症诊断后的中位时间为16年时，46%的癌症幸存者有一个激素轴功能障碍，24%有两个轴功能障碍，3%有三个轴功能障碍。20名癌症幸存者（14%）的激素水平与垂体功能障碍一致。垂体接受估计30格雷（Gy）或更高剂量辐射的癌症幸存者，在一个激素轴出现垂体功能障碍的风险增加（比值比[OR]3.16，置信区间[CI]1.02 - 9.87，p = 0.047），单独出现生长激素功能障碍的风险也增加（OR 2.96，CI 1.02 - 8.55，p = 0.045）。
头颈部放疗后激素值异常很常见。
随访期间可能需要筛查激素功能障碍。
