High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas
Abstract Background Cranial irradiation represents one of the first line treatment proposed in skull base meningiomas. While cranial irradiation is associated with a high risk of secondary hypopituitarism, few studies focused on the specific location of skull base meningiomas. Methods Fifty-two adul...
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BMC
2021-12-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-021-09045-3 |
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| author | Perrine Raymond Marc Klein Thomas Cuny Olivier Klein Julia Salleron Valérie Bernier-Chastagner |
| author_facet | Perrine Raymond Marc Klein Thomas Cuny Olivier Klein Julia Salleron Valérie Bernier-Chastagner |
| author_sort | Perrine Raymond |
| collection | DOAJ |
| description | Abstract Background Cranial irradiation represents one of the first line treatment proposed in skull base meningiomas. While cranial irradiation is associated with a high risk of secondary hypopituitarism, few studies focused on the specific location of skull base meningiomas. Methods Fifty-two adults receiving photon-beam therapy for skull base meningiomas between 2003 and 2014 in our Institution were included. Anterior pituitary (ACTH, FSH, GH, LH, TSH and prolactin) as well as corresponding peripheral hormones (8 am-Cortisol, IGF-1, fT3, fT4, 17βestradiol or testosterone) were biologically screened before radiotherapy (baseline), then yearly until March 2019. The pituitary gland (PG) was delineated on CT and the mean dose delivered to it was calculated. Results Mean age at diagnosis was 56 +/− 14 years. Median follow-up was 7 years. Up to 60% of patients developed at least ≥2 pituitary deficiencies, 10 years after radiotherapy. Gonadotroph, thyrotroph, corticotroph and somatotroph deficiencies occurred in 37, 28, 18 and 15% of patients, respectively. Hyperprolactinemia was found in 13% of patients. None patient had only one pituitary deficiency. In the multivariate analysis, a delivered dose to the PG ≥ 50 Gy or a meningioma size ≥40 mm significantly increased the risk of developing hypopituitarism. Conclusions Over a long-term follow-up, cranial radiation therapy used in skull base meningiomas led to a high prevalence of hypopituitarism, further pronounced in case of tumor ≥4 cm. These results advocate for an annual and prolonged follow-up of the pituitary functions in patients with irradiated skull base meningiomas. |
| first_indexed | 2024-12-19T12:55:35Z |
| format | Article |
| id | doaj.art-348025a2e6cc4f0a9998642365e2f992 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-19T12:55:35Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-348025a2e6cc4f0a9998642365e2f9922022-12-21T20:20:24ZengBMCBMC Cancer1471-24072021-12-012111910.1186/s12885-021-09045-3High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomasPerrine Raymond0Marc Klein1Thomas Cuny2Olivier Klein3Julia Salleron4Valérie Bernier-Chastagner5Department of radiation therapy, Institut de Cancérologie de LorraineDepartment of Endocrinology, University hospital CHU de NancyDepartment of Endocrinology, Hôpital de la Conception, Aix Marseille Univ, APHM, Inserm, MMGDepartment of Neurosurgery, University hospital CHU de NancyDepartment of biostatistics, Institut de Cancérologie de Lorraine, Université de Lorraine F-54519Department of radiation therapy, Institut de Cancérologie de LorraineAbstract Background Cranial irradiation represents one of the first line treatment proposed in skull base meningiomas. While cranial irradiation is associated with a high risk of secondary hypopituitarism, few studies focused on the specific location of skull base meningiomas. Methods Fifty-two adults receiving photon-beam therapy for skull base meningiomas between 2003 and 2014 in our Institution were included. Anterior pituitary (ACTH, FSH, GH, LH, TSH and prolactin) as well as corresponding peripheral hormones (8 am-Cortisol, IGF-1, fT3, fT4, 17βestradiol or testosterone) were biologically screened before radiotherapy (baseline), then yearly until March 2019. The pituitary gland (PG) was delineated on CT and the mean dose delivered to it was calculated. Results Mean age at diagnosis was 56 +/− 14 years. Median follow-up was 7 years. Up to 60% of patients developed at least ≥2 pituitary deficiencies, 10 years after radiotherapy. Gonadotroph, thyrotroph, corticotroph and somatotroph deficiencies occurred in 37, 28, 18 and 15% of patients, respectively. Hyperprolactinemia was found in 13% of patients. None patient had only one pituitary deficiency. In the multivariate analysis, a delivered dose to the PG ≥ 50 Gy or a meningioma size ≥40 mm significantly increased the risk of developing hypopituitarism. Conclusions Over a long-term follow-up, cranial radiation therapy used in skull base meningiomas led to a high prevalence of hypopituitarism, further pronounced in case of tumor ≥4 cm. These results advocate for an annual and prolonged follow-up of the pituitary functions in patients with irradiated skull base meningiomas.https://doi.org/10.1186/s12885-021-09045-3Skull base meningiomasRadiation therapyPituitary deficienciesIncrease morbi-mortality |
| spellingShingle | Perrine Raymond Marc Klein Thomas Cuny Olivier Klein Julia Salleron Valérie Bernier-Chastagner High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas BMC Cancer Skull base meningiomas Radiation therapy Pituitary deficiencies Increase morbi-mortality |
| title | High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas |
| title_full | High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas |
| title_fullStr | High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas |
| title_full_unstemmed | High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas |
| title_short | High prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas |
| title_sort | high prevalence of anterior pituitary deficiencies after cranial radiation therapy for skull base meningiomas |
| topic | Skull base meningiomas Radiation therapy Pituitary deficiencies Increase morbi-mortality |
| url | https://doi.org/10.1186/s12885-021-09045-3 |
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