Radiation Therapy for Pituitary Adenoma: Changes in Endocrine Function after Treatment

Yoon,  Sei Chul; Jang,  Hong Suck; Kim,  Song Whan; Shinn,  Kyung Sub; Bahk,  Yong Whee; Son,  Ho Young; Kang,  Joon Ki

J Korean Soc Ther Radiol > Volume 9(2); 1991 > Article

Original Article

Journal of the Korean Society for Therapeutic Radiology 1991;9(2): 185-195.

Radiation Therapy for Pituitary Adenoma: Changes in Endocrine Function after Treatment

Sei Chul Yoon, Hong Suck Jang, Song Whan Kim, Kyung Sub Shinn, Yong Whee Bahk, Ho Young Son, Joon Ki Kang

¹Department of Radiology, Catholic University Medical College, Seoul, Korea.
²Department of Internal Medicine, Catholic University Medical College, Seoul, Korea.
³Department of Neurosurgery, Catholic University Medical College, Seoul, Korea.

ABSTRACT

Seventy four patients with pituitary adenoma received radiation therapy(RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, kangnam St. mary's hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five (88%) patients were treated postoperatively and 9(12%) primary RT. To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin(PRL), growth hormone(GH), adrenocortiotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone(FSH) and thyroid stimulating hormone(TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turica with invasive tumor mass around supra-and/or parasella area. The patients were classified as 23(29%) prolactinomas and 20 (26%) growth hormone (GH) secreting tumors, and 6(8%) ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine(37%) had nonfunctioning tumor and four (5%) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15(65%) of 23 PRL and 3(15%) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively, Fifteen(20%) patients were lost to follow up atter RT.

Key Words: pituitary adenoma, Radiation therapy, Endocrinologic study, Functioning tumor, Non-functioning tumor