鼻窦和鼻咽恶性肿瘤放疗后垂体激素功能障碍的发生率。
Prevalence of pituitary hormone dysfunction following radiotherapy for sinonasal and nasopharyngeal malignancies.
机构信息
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
出版信息
Head Neck. 2023 Oct;45(10):2525-2532. doi: 10.1002/hed.27476. Epub 2023 Aug 3.
BACKGROUND
There are limited studies and no surveillance protocols on pituitary dysfunction for adults who underwent anterior skull base radiation.
METHODS
Cross-sectional study of 50 consecutive patients with sinonasal or nasopharyngeal cancer who underwent definitive radiotherapy. The mean radiation doses, prevalence of pituitary dysfunction, and associated factors were calculated.
RESULTS
Pituitary hormone levels were abnormal in 23 (46%) patients, including 6 (12%) with symptomatic abnormalities requiring treatment. The most common hormonal abnormality was hyperprolactinemia (30%), central hypothyroidism (8%) and central hypogonadism (6%). Patients with abnormal pituitary hormone values received higher mean radiation doses to the pituitary gland (1143 cGy, P = 0.04), pituitary stalk (1129 cGy, P = 0.02), optic chiasm (1094 cGy, P = 0.01), and hypothalamus (900 cGy, P = 0.01).
CONCLUSIONS
Nearly half of the patients had abnormal pituitary function, including over a tenth requiring treatment. There may be a dose-dependent association between hormonal dysfunction and radiation.
背景
对于接受颅前底放疗的成年人，关于垂体功能障碍的研究有限，也没有监测方案。
方法
对 50 例接受根治性放疗的鼻腔鼻窦或鼻咽部癌症患者进行了一项横断面研究。计算了平均放射剂量、垂体功能障碍的患病率和相关因素。
结果
23 名（46%）患者的垂体激素水平异常，其中 6 名（12%）有需要治疗的症状性异常。最常见的激素异常是高催乳素血症（30%）、中枢性甲状腺功能减退（8%）和中枢性性腺功能减退（6%）。垂体激素值异常的患者接受了更高的垂体（1143 戈瑞，P=0.04）、垂体柄（1129 戈瑞，P=0.02）、视交叉（1094 戈瑞，P=0.01）和下丘脑（900 戈瑞，P=0.01）的平均放射剂量。
结论
近一半的患者出现垂体功能异常，其中超过十分之一需要治疗。激素功能障碍与放射之间可能存在剂量依赖性关联。
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