{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:31:52Z","timestamp":1791937912669,"version":"4.3.4"},"reference-count":55,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004861","name":"Mackay Memorial Hospital","doi-asserted-by":"publisher","award":["MMH-E-109-13"],"award-info":[{"award-number":["MMH-E-109-13"]}],"id":[{"id":"10.13039\/501100004861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004861","name":"Mackay Memorial Hospital","doi-asserted-by":"publisher","award":["MMH-E-108-13"],"award-info":[{"award-number":["MMH-E-108-13"]}],"id":[{"id":"10.13039\/501100004861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004861","name":"Mackay Memorial Hospital","doi-asserted-by":"publisher","award":["103AS-9.2.1-FD-Z2"],"award-info":[{"award-number":["103AS-9.2.1-FD-Z2"]}],"id":[{"id":"10.13039\/501100004861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004861","name":"Mackay Memorial Hospital","doi-asserted-by":"publisher","award":["MMH-E-111-11"],"award-info":[{"award-number":["MMH-E-111-11"]}],"id":[{"id":"10.13039\/501100004861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 109-2314-B-195-003-MY3"],"award-info":[{"award-number":["MOST 109-2314-B-195-003-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Incidental radiotherapy (RT) to the adrenal gland may have systemic effects. This study aimed to investigate the effects of adrenal RT on fatigue. Methods: BALB\/c mice were surgically explored to identify the left adrenal gland and delivered intra-operative RT. The swimming endurance test was used for endurance assessment to represent fatigue. Plasma levels of stress hormones and histopathological features were examined. Three patients with inevitable RT to the adrenal gland were enrolled for the preliminary study. Serum levels of cortisol, aldosterone, and adrenocorticotropic hormone (ACTH) were measured before and after RT. Fatigue score by using the fatigue severity scale and RT dosimetric parameters were collected. Results: In the experimental mouse model, adrenal RT decreased baseline cortisol from 274.6 \u00b1 37.8 to 193.6 \u00b1 29.4 ng\/mL (p = 0.007) and swimming endurance time from 3.7 \u00b1 0.3 to 1.7 \u00b1 0.6 min (p = 0.02). In histopathological assessment, the irradiated adrenal glands showed RT injury features in the adrenal cortex. In the enrolled patients, baseline cortisol significantly declined after RT. There were no significant differences in the levels of morning cortisol, aldosterone, and ACTH before and after RT. Conclusions: The RT dose distributed to the adrenal gland may correlate with unwanted adverse effects, including fatigue and adrenal hormone alterations.<\/jats:p>","DOI":"10.3390\/jcm11051214","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T07:22:35Z","timestamp":1645687355000},"page":"1214","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Adrenal Gland Irradiation Causes Fatigue Accompanied by Reactive Changes in Cortisol Levels"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4629-326X","authenticated-orcid":false,"given":"Yu-Ming","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, MacKay Memorial Hospital, Taipei 104, Taiwan"},{"name":"Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan"},{"name":"Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Wen","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Medical Research, MacKay Memorial Hospital, Taipei 104, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4823-9582","authenticated-orcid":false,"given":"Pao-Shu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan"},{"name":"Department of Pathology, MacKay Memorial Hospital, Taipei 104, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Chi","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, MacKay Memorial Hospital, Taipei 104, Taiwan"},{"name":"Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Nan","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan"},{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9794-8938","authenticated-orcid":false,"given":"Yu-Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, MacKay Memorial Hospital, Taipei 104, Taiwan"},{"name":"Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan"},{"name":"Department of Medical Research, MacKay Memorial Hospital, Taipei 104, Taiwan"},{"name":"Department of Artificial Intelligence and Medical Application, MacKay Junior College of Medicine, Nursing, and Management, New Taipei City 252, Taiwan"},{"name":"Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.6004\/jnccn.2015.0122","article-title":"Cancer-related fatigue, version 2.2015","volume":"13","author":"Berger","year":"2015","journal-title":"J. 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