{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T06:18:42Z","timestamp":1771741122651,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T00:00:00Z","timestamp":1555372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Childhood brain tumour survivors who receive cranial radiotherapy undergo regular surveillance for the development ofhypothalamic\u2010pituitary (HP) axis dysfunction. Much less attention has been given to radiation\u2010induced hypopituitarism in patients with malignant brain tumours of adult onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Measurements<\/jats:title><jats:p>We assessed the effects of cranial radiotherapy (cXRT) on pituitary function in 58 adults (32 male) with gliomas distant to the HP axis. The XRT dose exposure at the HP axis was correlated with individual axis dysfunction to establish dose thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age at cXRT was 41.2\u00a0\u00b1\u00a010.9\u00a0years and duration of endocrine follow\u2010up 8.2\u00a0\u00b1\u00a05.2\u00a0years. Mean XRT dose to the HP axis was 35.9\u00a0\u00b1\u00a015.5\u00a0Gy. Overall prevalence of radiation\u2010induced hypopituitarism was 84.5%. GH, LH\/FSH, ACTH and TSH deficiency were present in 82.8%, 20.7%, 19% and 6.9% of patients, respectively. Hyperprolactinaemia was noted in 10.3% (n\u00a0=\u00a06) and was persistent in one case. GH deficiency and \u201cany degree of hypopituitarism\u201d positively correlated with the radiotherapy dose to the hypothalamic\u2010pituitary axis. HP axis XRT dose thresholds for the development of GHD, LH\/FSH, ACTH and TSH deficiency were established at 10, 30, 32 and 40.8\u00a0Gy, respectively. A gradual increase in the prevalence of all anterior pituitary hormone deficits was observed throughout the follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hypopituitarism post\u2010cXRT in adults with gliomas is a frequent, progressive and dose\u2010dependent phenomenon. Dose thresholds suggest long\u2010term endocrine surveillance is important where the HP axis XRT dose is higher than 30\u00a0Gy. Identification of deficits to allow early and appropriate hormone replacement therapy is important to improve well\u2010being in these individuals with limited prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13971","type":"journal-article","created":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T07:50:30Z","timestamp":1552636230000},"page":"131-140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Hypothalamic\u2010pituitary axis irradiation dose thresholds for the development of hypopituitarism in adult\u2010onset gliomas"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6414-5629","authenticated-orcid":false,"given":"Nikolaos","family":"Kyriakakis","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes &amp; Endocrinology St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes &amp; Endocrinology St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve M.","family":"Orme","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes &amp; Endocrinology St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgina","family":"Gerrard","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Leeds Cancer Centre St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Hatfield","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Leeds Cancer Centre St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan C.","family":"Short","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Leeds Cancer Centre St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmel","family":"Loughrey","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Leeds Cancer Centre St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6730-6109","authenticated-orcid":false,"given":"Robert D.","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes &amp; Endocrinology St James\u2019s University Hospital, Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1677\/erc.1.00779"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(75)90006-9"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1525"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12969"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.17269\/cjph.107.5209"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.67.9.1107"},{"issue":"287","key":"e_1_2_9_8_1","first-page":"265","article-title":"Endocrine and reproductive dysfunction following fractionated total body irradiation in adults","volume":"78","author":"Littley MD","year":"1991","journal-title":"Q J Med"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.02.015"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2055"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/31372149"},{"key":"e_1_2_9_12_1","unstructured":"NICE.Technology appraisal #64. 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