Endocrine Abstracts

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

Materials and methods: Thirty patients surveyed after receiving radiation therapy (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 36–71 years. 37% of them had pituitary macroadenoma with para-, supra-, infrasellar growth. Duration of illness was on average 15 years. Period of observation after RT averaged 10 years. The levels of GH, IGF1, PRL, TSH, LH, FSH, fr.T4, cortisol, estradiol, testosterone, CT/MRI of the brain covering pituitary, visual field and acuity tests, fundoscopy were assesed. All patients received RT in combination with drug therapy. Six of them (20%) received RT on the background of drug therapy, 11 (37%) after the TAG and 13 (43%) were primary. To assess the consequences of RT we checked all parameters before (I group) and a year or more after RT (II group).

Results of the study: 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 fr.T4 in 17%, cortisol in 10%, decreased visual acuity in 30%, menstrual disorder in 62%, impaired potency in 11% of patients. Group II showed the following results: GH (M=33) and IGF1 (M=434) in 38%, PRL in 9%; decreased gonadotrpins in 80%, TSH and fr.T4 in 30%, cortisol in 50%, menstrual disorder in 67%, impaired potency in 33%, decreased visual acuity in 57% of patients. Moreover, 20% developed ESS, 3% necrosis of brain tissue.

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