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    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2018 Oct 30. pii: S0167-8140(18)33538-2. doi: 10.1016/j.radonc.2018.10.014
    Are hypothyroidism and hypogonadism clinically relevant in patients with malignant gliomas? A longitudinal trial in patients with glioma.
    Handisurya A1,  Rumpold T2,  Caucig-Lütgendorf C3,  Flechl B4,  Preusser M5,  Ilhan-Mutlu A6,  Dieckmann K7,  Widhalm G8,  Grisold A9,  Wöhrer A10,  Hainfellner J11,  Ristl R12,  Kurz C13,  Marosi C14,  Gessl A15,  Hassler M16
    Author information
    1Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Austria.
    2Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria.
    3MedAustron Ion Therapy Center, Wiener Neustadt, Austria.
    4MedAustron Ion Therapy Center, Wiener Neustadt, Austria; Institute of Radiooncology, Kaiser Franz-Josef Spital SMZ-Süd, Vienna, Austria.
    5Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria.
    6Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria.
    7Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria.
    8Department of Neurosurgery, Medical University of Vienna, Austria.
    9Department of Neurology, Medical University of Vienna, Austria.
    10Institute of Neurology, Medical University of Vienna, Austria.
    11Institute of Neurology, Medical University of Vienna, Austria.
    12Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria.
    13Department of Department of Obstetrics and Gynecology, Medical University of Vienna, Austria.
    14Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria. Electronic address: christine.marosi@meduniwien.ac.at.
    15Department of Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Austria.
    16Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria.
    Abstract

    BACKGROUND: So far, the development and course of therapy-induced deficiencies in hypothalamic-pituitary hormones in adult patients with malignant gliomas has not received much attention. However, such deficiencies may impact patient's quality of life substantially.

    METHODS: In this monocentric longitudinal trial, we examined hormonal levels of TSH, T3, T4, fT3, fT4, FSH, LH, testosterone, estradiol and prolactin in patients with malignant high grade gliomas before the start of radiochemotherapy (RCT), at the end of RCT and then every three months for newly diagnosed patients and every six months in patients diagnosed more than two years before study inclusion. Growth hormone was not measured in this trial.

    RESULTS: 436 patients (198 female, 238 male) with high-grade gliomas, aged 19-83 years (median 50 years), were included in this study. Low levels of thyroid hormones were observed in around 10% of patients within the first six months of follow up and increasingly after 36 months. Half of premenopausal women at study entry developed premature menopause, 35% showed hyperprolactinemia. Low testosterone levels were measured in 37% of men aged less than 50 years and in 35/63 (55%) of men aged 50 years or older.

    DISCUSSION: The results of this study show that a significant percentage of patients with malignant gliomas develop hormonal deficiencies mandating regular clinical follow up, state of the art counseling and if clinically necessary substitution therapy.


    Copyright © 2018 Elsevier B.V. All rights reserved.

    KEYWORDS: Adult brain tumor patients, Hypothalamic–pituitary hormones, Radiation induced hormonal deficits

    Publikations ID: 30389240
    Quelle: öffnen
     
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