{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:03:51Z","timestamp":1792433031245,"version":"4.5.0"},"reference-count":40,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2015,2,10]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To estimate the prevalence of and risk factors for growth hormone deficiency (GHD), luteinizing hormone\/follicle-stimulating hormone deficiencies (LH\/FSHD), thyroid-stimulatin hormone deficiency (TSHD), and adrenocorticotropic hormone deficiency (ACTHD) after cranial radiotherapy (CRT) in childhood cancer survivors (CCS) and assess the impact of untreated deficiencies. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Retrospective study in an established cohort of CCS with 748 participants treated with CRT (394 men; mean age, 34.2 years [range, 19.4 to 59.6 years] observed for a mean of 27.3 years [range, 10.8 to 47.7 years]). Multivariable logistic regression was used to study associations between demographic and treatment-related risk factors and pituitary deficiencies, as well as associations between untreated deficiencies and cardiovascular health, bone mineral density (BMD), and physical fitness. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The estimated point prevalence was 46.5% for GHD, 10.8% for LH\/FSHD, 7.5% for TSHD, and 4% for ACTHD, and the cumulative incidence increased with follow-up. GHD and LH\/FSHD were not treated in 99.7% and 78.5% of affected individuals, respectively. Male sex and obesity were significantly associated with LH\/FSHD; white race was significant associated with LH\/FSHD and TSHD. Compared with CRT doses less than 22 Gy, doses of 22 to 29.9 Gy were significantly associated with GHD; doses \u2265 22 Gy were associated with LH\/FSHD; and doses \u2265 30 Gy were associated with TSHD and ACTHD. Untreated GHD was significantly associated with decreased muscle mass and exercise tolerance; untreated LH\/FSHD was associated with hypertension, dyslipidemia, low BMD, and slow walking; and both deficits, independently, were associated with with abdominal obesity, low energy expenditure, and muscle weakness. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Anterior pituitary deficits are common after CRT. Continued development over time is noted for GHD and LH\/FSHD with possible associations between nontreatment of these conditions and poor health outcomes. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2014.56.7933","type":"journal-article","created":{"date-parts":[[2015,1,6]],"date-time":"2015-01-06T04:16:09Z","timestamp":1420517769000},"page":"492-500","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":252,"title":["Anterior Hypopituitarism in Adult Survivors of Childhood Cancers Treated With Cranial Radiotherapy: A Report From the St Jude Lifetime Cohort Study"],"prefix":"10.1200","volume":"33","author":[{"given":"Wassim","family":"Chemaitilly","sequence":"first","affiliation":[{"name":"Wassim Chemaitilly, Zhenghong Li, Sujuan Huang, Kirsten K. Ness, Karen L. Clark, Daniel M. Green, Nicole Barnes, Gregory T. Armstrong, Matthew J. Krasin, Deo Kumar Srivastava, Ching-Hon Pui, Thomas E. Merchant, Larry E. Kun, Amar Gajjar, Melissa M. 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