Endocrine Abstracts

The purpose of the study: To examine the incidence of neuroendocrine complications after radiation therapy (RT) of pituitary somatotropinomas.

Materials and methods: 30 patients surveyed after receiving RT at a dose of 45 g in 25 fractions a day. Of these, 21 (70%) females, 9 (30%) men. The age of patients ranged from 36 to 71 years. 37% of them had pituitary macroadenoma with para-, supra-, and infrasellar growth. Duration of illness was 15 years on average. Period of observation after RT averaged to 10 years. The levels of GH, IGF1, PRL, TSH, LH, FSH, fT₄, cortisol, oestradiol, testosterone, CT/MRI of the brain covering pituitary, visual field and acuity tests, and fundoscopy were assessed. All patients received RT in combination with drug therapy. 6 (20%) received RT with drug therapy, 11 (37%) after TAG and 13 (43%) were primary. All parameters were checked before (I group) and a year or more after RT (II group).

Results: The following impairments took place in I group: increased GH (M=107), IGF1 (M=1138) in 75%, and PRL in 33%; decreased gonadotropins in 80%, TSH and fT₄ in 17%, cortisol in 10%, decreased visual acuity in 30%, menstrual disorder in 62%, and impaired potency in 11% of patients. Group II showed following results: GH (M=33) and IGF1 (M=434) in 38%, PRL in 9%; decreased gonadotropins in 80%, TSH and fT₄ in 30%, cortisol in 50%, menstrual disorder in 67%, impaired potency in 33%, and decreased visual acuity in 57% of patients. Moreover, 20% developed ESS and 3% necrosis of brain tissue.

Conclusions: RT in pituitary somatotropinomas leads to the stabilization of the pathological process.