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Endocrine-Related Cancer 16 (3) 733 -772     DOI: 10.1677/ERC-08-0231
Copyright © 2009 by the Society for Endocrinology
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REVIEW

Radiation-induced hypopituitarism

 Alberto Fernandez, Michael Brada1, Lina Zabuliene2, Niki Karavitaki and John A H Wass

Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, UK
1 The Institute of Cancer Research and The Royal Marsden National Health Service Foundation Trust, Sutton, Surrey, UK
2 Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania

(Correspondence should be addressed to J A H Wass; Email: john.wass{at}noc.anglox.nhs.uk)

The hypothalamic–pituitary unit is a particularly radiosensitive region in the central nervous system. As a consequence, hypopituitarism commonly develops after radiation treatments for sellar and parasellar neoplasms, extrasellar brain tumours, head and neck tumours, and following whole body irradiation for systemic malignancies. Increasing tumour-related survival rates provide an expanding population at risk of developing hypopituitarism. In this population, long-term monitoring tailored to the individual risk profile is required to avoid the sequelae of untreated pituitary hormonal deficiencies and resultant decrease in the quality of life. This review analyses the pathogenesis, prevalence and consequences of radiation-induced hypopituitarism (RIH) in diverse subgroups at risk. Also discussed is the impact of modern radiotherapy techniques in the prevalence of RIH, the spectrum of endocrine disorders and radiation-induced brain conditions that also occur in patients with RIH.






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