[Hyperprolactinemia in patients with brain radiotherapy]

Endocrinopathy is a known consequence of external beam radiotherapy to the brain tumors. The aim of this study was to find out the incidence of hyperprolactinemia in brain tumor patients treated with radiotherapy, when radiation portals included whole of the hypothalamus and pituitary glands. This descriptive study was conducted from December 2004 to February 2006 on about 42 patients with brain tumors, who were referred to radiation oncology center of Hamadan to be treated with external beam radiotherapy, whose radiation portals included whole hypothalamus and pituitary glands. Serum prolactin levels were measured at the beginning of treatment, and at one month, three months, six months and one year after completion of radiotherapy. Data was introduced using descriptive statistics. Of 42 patients 6 were excluded which one was because pf previous hypothalamus and pituitary radiotherapy, three because of nonadherence to follow up program and two because of previous endocrinopathy of the patients attending the follow up clinic, 11% were found to have hyperprolactinemia at six months and 22 at one year. This condition in women and men was 37% and 15% respectively. Abnormality in prolactine secretion is a late complication of brain radiotherapy and a significant number of patients develop hyperprolactinoma following radiotherapy to the brain [hypothalamus and pituitary region]. It seems this complication increases by increasing the radiation dose and is more prevalent in women

Efeitos tardios na funçäo hipotálamo-hipófise após tratamento de tumores parasselares / Late effects on the hypothalamo pituitary function the treatment of parasellar tumors

O acompanhamento a longo prazo de pacientes submetidos a tratamento de tumores da regiäo parasselar é importante para detectar complicaçöes tardias da terapêutica. Neste estudo avaliamos 6 pacientes com craniofaringioma, 1 com meningioma, 1 com germinoma e 1 com cisto epidermóide, localizados na regiäo parasselar. Eles haviam sido tratados, em média, 3,8 ñ 3,2 anos antes, por cirurgia e radioterapia (6 casos) ou somente cirurgia (3 casos). Cinco pacientes eram do sexo feminino e a média de idade era de 24,3 ñ 18,8 anos. A avaliaçäo consistiu na infusäo endovenosa de TRH (200 µg), GnRH (100 µg) e insulina regular (0,1 UI Kg/peso), bem como na dosagem dos hormônios hipofisários antes (0) e após 20, 40, 60 e 80 minutos. Encontramos os seguintes resultados: (a) resposta deficitária do GH e do cortisol em todos pacientes; (b) 7/9 pacientes näo tiveram repostas adequadas do FSH e 3/9 do LH; (c) 4/9 tiveram respostas inadequadas da prolactina e 2/8 do TSH. Concluimos que: (a) o déficit de GH e cortisol säo os mais frequentes nestes pacientes; (b) a lesäo após radioterapia pode localizar-se tanto no hipotálamo quanto na hipóise ou, ainda, em ambos; (c) sa sensibilidade das células hipofisárias e hipotalâmicas à irradiaçäo é diferente de acordo com os hormônios que produzem; (d) é necessário o acompanhamento endocrinológico frequente dos pacientes submetidos a tratamento de tumores parasselares, a fim de detectar déficits hormonais tardios