SFEBES2023 Poster Presentations Neuroendocrinology and Pituitary (74 abstracts)
The effect of gamma knife radiosurgery on the endocrine profile in patients with non-sellar pathologies: A short-term study
Rupinder Kaur 1 , Jenil Gurnaani 1 , Ashutosh Rai 2 , Pinaki Dutta 1 , Narendra Kumar 1 , Chirag K Ahuja 1 , Rajesh Chhabra 1 , Sandeep Mohindra 1 & Manjul Tripathi 1
1Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2Queen Mary University of London, London, United Kingdom
Introduction: Hypopituitarism is the most frequent side effect of radiation or gamma knife radiosurgery (GKRS) for sellar diseases. There is a paucity of literature on the impact of GKRS on the hormonal profile of non-sellar diseases, even though the impact of radiation on pituitary hormones has been widely explored in sellar as well as non-sellar pathologies. In patients receiving treatment for non-sellar diseases, we assessed the effect of GKRS on hormonal profile.
Methods: 100 patients receiving GKRS for non-sellar pathologies between 2013-2017 were included in this study. Calculations were made for the maximum and average dose fall to the pituitary gland using a dose volume histogram (DVH) plot. Endocrine examinations at the baseline and follow-up (1 year) were carried out, compared to the normal reference range, and associated with the DVH.
Results: Sixteen patients showed hypocortisolism and we observed a significant decrease (P=0.0027) in serum cortisol levels post-GKRS (106.7±14.27) as compared to baseline (288.9±50.29). At follow-up, male (n=5) patients had (P=0.007) lower ACTH levels (22.6±2.65) compared to baseline (45±4.37). Six percent of patients showed new onset of IGF-1 deficiency in 6% (6/100). Hypothyroidism was not observed in our cohort. In the gonadotrophic axis, females had lower mean LH (25.2±4.34) after treatment as compared to pre-treatment (32.64±4.54) (P=0.04) in the supratentorial group, and this decrease in LH levels was more pronounced in infratentorial group (P=0.006). There was a significant increase in post-GKRS mean serum prolactin (20.66±6.69) in comparison to baseline (15.69±6.23) in females receiving 2-5 Gy radiation (P=0.04), indicating hypothalamic damage.
Conclusion: In patients receiving treatment for non-sellar diseases, our data demonstrate a considerable alteration in hormonal profile. Even at exposure levels of 1Gy, the clinical effects of this damage are most noticeable in the corticotroph and gonadotroph axis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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