{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:06:36Z","timestamp":1753891596165,"version":"3.41.2"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Brain radiotherapy often results in impairment of hypothalamic\u2013pituitary (HT-P) function, which in turn causes secretory dysfunction of related hormones. In this paper, the frequency of metastasis in the HT-P area and its high-risk factors in patients with brain metastasis were retrospectively analyzed, and thus provide experimental evidence for protecting HT-P area during whole brain radiotherapy (WBRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed on the data of patients with brain metastasis diagnosed by cranial magnetic resonance imaging (MRI) at the First Hospital of Lanzhou University from 2017 to 2020. The anatomical positions of the hypothalamus and pituitary were delineated, followed by their expansion by 5\u2009mm outwards, respectively, in the three-dimensional direction, and the hypothalamus +5\u2009mm and pituitary +5\u2009mm were obtained as the avoidance area, in which the frequency of brain metastasis was evaluated. Univariate and multivariate logistic regression models were used to analyze the high risk factors of brain metastasis in HT-P area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3,375 brain metastatic lesions from 411 patients were included in the analysis. The rates of brain metastasis in the hypothalamus +5\u2009mm and pituitary +5\u2009mm in the whole group of cases were 2.9% (12\/411) and 1.5% (6\/411) respectively; the frequency of lesions was 0.4% (13\/3375) and 0.2% (6\/3375) respectively. Univariate and multivariate analyses showed that the number of brain metastases (OR\u2009=\u200914.946; 95% CI\u2009=\u20094.071\u201354.880; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001), and the occurrence of brain metastasis in the pituitary (OR\u2009=\u200913.331; 95% CI\u2009=\u20091.511\u2013117.620; <jats:italic>p<\/jats:italic>\u2009=\u20090.020) were related to brain metastasis in the hypothalamus, and that the only relevant factor for brain metastasis in the pituitary was the occurrence of that in the hypothalamus (OR\u2009=\u20090.069; 95% CI\u2009=\u20090.010\u20130.461; <jats:italic>p<\/jats:italic>\u2009=\u20090.006). There was no correlation between tumor pathological types, the maximum diameter, the total volume of brain metastatic lesions and the risk of brain metastasis in hypothalamus and pituitary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The frequency of brain metastasis in the HT-P area is extremely low. The risk of brain metastases in the hypothalamus is correlated with their number. The larger the number of metastatic lesions, the higher the frequency of brain metastasis. Protection of the HT-P area during WBRT may be unlikely to compromise the tumor recurrence rate for patients with a relatively small number of brain metastases.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1285662","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T07:17:00Z","timestamp":1701328620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Frequency of metastases within the hypothalamic\u2013pituitary area and the associated high-risk factors in patients with brain metastases"],"prefix":"10.3389","volume":"14","author":[{"given":"Peng","family":"Xie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiling","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiong","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Lan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruifeng","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Yue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenteng","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1200\/JCO.2005.04.6185","article-title":"Whole-brain radiotherapy in the management of brain metastasis","volume":"24","author":"Khuntia","year":"2006","journal-title":"J Clin Oncol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00066-014-0808-9","article-title":"Whole brain irradiation with hippocampal sparing and dose escalation on multiple brain metastases: local tumour control and survival","volume":"191","author":"Oehlke","year":"2015","journal-title":"Strahlenther Onkol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2004","DOI":"10.1016\/S0140-6736(16)30825-X","article-title":"Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority, randomised trial","volume":"388","author":"Mulvenna","year":"2016","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e277","DOI":"10.1016\/S1470-2045(16)30065-1","article-title":"Prophylactic cranial irradiation for patients with lung cancer","volume":"17","author":"Pechoux","year":"2016","journal-title":"Lancet Oncol"},{"key":"ref5","first-page":"659","article-title":"Pathogenesis of irradiation-induced cognitive (lysfunction)","volume":"35","author":"Abayomi","year":"1996","journal-title":"ActaOnc-ol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.radonc.2010.09.013","article-title":"Why avoid the hippocampus? 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