ENDOCRINE FUNCTIONS IN LONG-TERM SURVIVORS OF LOW-GRADE SUPRATENTORIAL GLIOMA TREATED WITH RADIATION-THERAPY

Endocrine functions were studied in long-term survivors of low-grade g lioma treated with radiotherapy. Hypothalamic-pituitary dysfunction ha s recently been reported to occur more frequently than generally consi dered. Because endocrine dysfunction is a treatable condition, careful testing and, if necessary, supplementary treatment may enhance qualit y of life. Thirteen adult patients treated with radiotherapy because o f supratentorial low-grade glioma at least one year before (range 1-11 .5 years) were tested. Focal brain radiotherapy (45-61.2 Gy), with cal culated dose to the hypothalamic-pituitary area ranging from 0 to 50 G y (mean 36.1) had been applied to all patients. Serum levels of pituit ary hormones, cortisol and thyroid hormone were determined before and after stimulation with hypothalamic hormones. In 10 out of 13 patients one or more hormonal values were out of the normal range. Most distur bances were demonstrated in the pituitary-adrenal axis (8 patients) an d the GH-axis (4 patients). None of the patients had clinical symptoma tology of adrenal, thyroid or gonadal dysfunction. Careful endocrine t esting after cranial radiotherapy may reveal (subclinical) hypothalami c-pituitary dysfunction in long-term survivors. Follow-up testing in t hese patients seems warranted.