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This Article Accepted manuscript (PDF) All Versions of this Article: ERC-08-0231v1 16/3/733    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fernandez, A. Articles by Wass, J. Search for Related Content PubMed PubMed Citation Articles by Fernandez, A. Articles by Wass, J.

A Fernandez, Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom
M Brada, Insitute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
L Zabuliene, Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
N Karavitaki, Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom
J Wass, Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom

Correspondence: John Wass, Email: john.wass{at}noc.anglox.nhs.uk

Abstract

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 and head and neck tumours and following whole body irradiation for systemic malignancies. The increasing 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 quality of life. This review analyzes the pathogenesis, prevalence and consequences of radiation-induced hypopituitarism (RIH) in diverse subgroups at risk. The impact of modern radiotherapy techniques on the prevalence of RIH and the spectrum of endocrine disorders and radiation-induced brain conditions that also occur in patients with RIH is also discussed.