The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Hypothalamic-Pituitary Dysfunction after Radiation for Brain Tumors
Open accessAbstract
BACKGROUND: Patients with brain tumors who are treated with radiation frequently have growth hormone deficiency, but other neuroendocrine abnormalities are presumed to be uncommon. METHODS: We studied endocrine function in 32 patients (age, 6 to 65 years) 2 to 13 years after they had received cranial radiotherapy for brain tumors. The doses of radiation to the hypothalamic-pituitary region ranged from 3960 to 7020 rad (39.6 to 70.2 Gy). Nine patients also received 1800 to 3960 rad (18.0 to 39.6 Gy) to the craniospinal axis. Serum concentrations of thyroid, gonadal, and pituitary hormones were measured at base line and after stimulation. RESULTS: Nine patients (28 percent) had symptoms of thyroid deficiency, and 20 patients (62 percent) had low serum total or free thyroxine or total triiodothyronine concentrations. Of the 23 patients treated only with cranial radiation, 15 (65 percent) had hypothalamic or pituitary hypothyroidism. Of the nine patients who also received spinal (and thus direct thyroid) radiation, three (33 percent) had evidence of primary thyroid injury. Seven of the 10 postpubertal, premenopausal women (70 percent) had oligomenorrhea, and 5 (50 percent) had low serum estradiol concentrations. Three of the 10 men (30 percent) had low serum testosterone concentrations. Overall, 14 of the 23 postpubertal patients (61 percent) had evidence of hypogonadism. Mild hyperprolactinemia was present in 50 percent of the patients. Responses to stimulation with corticotropin-releasing hormone and corticotropin were normal in all patients except one, who had panhypothalamic dysfunction. However, serum 11-deoxycortisol responses to the administration of metyrapone were low in 11 of the 31 patients (35 percent) tested. Three of the 32 patients, (9 percent) had no endocrine abnormalities, 9 (28 percent) had an abnormal result on tests of thyroid, gonadal, prolactin, or adrenal function, 8 (25 percent) had abnormalities in two axes, 8 (25 percent) in three axes, and 4 (12 percent) in all four axes. CONCLUSIONS: Cranial radiotherapy in children and adults with brain tumors frequently causes abnormal hypothalamic-pituitary function. The most frequent changes are hypothyroidism and gonadal dysfunction, although subtle abnormalities in adrenal function may also be present.
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“Hypothyroidism has been described in up to 65% of cases many years after conventional radiotherapy (Constine et al., 1993;Kyriakakis et al., 2015;Snyder et al., 1986).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Constine et al., 1993
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“oral oestrogen replacement increases all binding proteins by stimulating their hepatic synthesis.”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Constine et al., 1993
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“but also putting a further strain on the production of thyroid hormones in cases of mild or latent hypothyroidism on the other (Constine et al., 1993;Feldt-Rasmussen, 2018;Filipsson and Johannsson, 2009).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Constine et al., 1993
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“The subsequent increased thyroxine binding globulin therefore challenges the interpretation of thyroid hormone measurements on the one hand”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Constine et al., 1993
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Cites
Andrews, J. R., Rubin, P., & Casarett, G. W. (1968) · Radiation Research · doi:10.2307/3572601 · Cited by 916
RADIATION‐INDUCED HYPOPITUITARISM IS DOSE‐DEPENDENT
Littley, M. D., Shalet, S. M., Beardwell, C. G., ROBINSON, E. L., & Sutton, M. (1989) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1989.tb01260.x · Cited by 271
Thyroid dysfunction after radiotherapy in children with Hodgkin's disease
Constine, L. S., Donaldson, S. S., McDougall, I. R., Cox, R. S., Link, M. P., & Kaplan, H. S. (1984) · Cancer · doi:10.1002/1097-0142(19840215)53:4 · Cited by 231
Schürmeyer, T. H., Avgerinos, P. C., Gold, P. W., Gallucci, W. T., Tomai, T. P., Cutler, G. B., Loriaux, D. L., & Chrousos, G. P. (1984) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-59-6-1103 · Cited by 206
THE EFFECT OF VARYING DOSES OF CEREBRAL IRRADIATION ON GROWTH HORMONE PRODUCTION IN CHILDHOOD
Shalet, S. M., Beardwell, C. G., Pearson, D., & Jones, P. H. M. (1976) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1976.tb01955.x · Cited by 198
Growth and Endocrine Disorders Secondary to Cranial Irradiation
Rappaport, R., & Brauner, R. (1989) · Pediatric Research · doi:10.1203/00006450-198906000-00001 · Cited by 193
Dose dependency of time of onset of radiation-induced growth hormone deficiency
Clayton, P., & Shalet, S. M. (1991) · The Journal of Pediatrics · doi:10.1016/s0022-3476(05)80487-1 · Cited by 192
Quigley, C. A., Cowell, C. T. C. T., Jimenez, M., Burger, H., Kirk, J., Bergin, M., Stevens, M. M., Simpson, J. M., & Silink, M. (1989) · New England Journal of Medicine · doi:10.1056/nejm198907203210303 · Cited by 184
LAM, K., TSE, V., Wang, C., Yeung, R. T., & Ho, J. (1991) · QJM · doi:10.1093/oxfordjournals.qjmed.a068535 · Cited by 180
GLATSTEIN, E. J., McHardy-Young, S., Brast, N., Eltringham, J. R., & Kriss, J. P. (1971) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-32-6-833 · Cited by 165
Research works printed but not linked: 9
- Brunner H, 1920, Arch Klin Chir, 114, 332
- Kelly KH, 1951, J Natl Cancer Inst, 11, 967
- Samaan NA, 1987, J Lab Clin Med, 109, 364
- Lam KSL, 1991, Q J Med, 78, 165
- Some methods based on ranks. In: Conover WJ. Practical nonparametric statistics. 2nd ed. New York: John Wiley, 1980:215-8.
- Measures of association for ordinal variables. In: Agresti A. Analysis of ordinal categorical data. New York: John Wiley, 1984:161-3.
- Dickerman Z, 1976, Am J Dis Child, 130, 634
- Sklar CA, 1991, Pediatrician, 18, 53
- Ramsay N, 1978, Proc Am Assoc Cancer Res Proc Am Soc Clin Oncol, 19, 389
Cited by
Sorted by citations
Items 601–618 of 618
Krankheitsbezogene Schlafstörungen
Dauelsberg, T., & Strik, H. M. (2022) · Springer Reference Medizin · doi:10.1007/978-3-662-46764-0_327-1
Sevillano, S. B., Cabanillas‐Lazo, M., Sedano-Chiroque, F. L., Escajadillo-Vergara, C., Espinoza-Martinez, D., & Pinedo-Torres, I. A. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-078595
Endocrine late effects in childhood cancer survivors
Chemaitilly, W., & Cohen, L. E. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00037-6
Wong, L. L., & Verbalis, J. G. (2002) · Humana Press eBooks · doi:10.1007/978-1-59259-277-7_3
Pediatric Neuro-Oncology: An Overview
Packer, R. J. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-10944-7.00143-8
Leidenberger, F. A. (1998) · Springer eBooks · doi:10.1007/978-3-662-08108-2_14
Radiation Therapy in the Management of Pediatric Brain Tumors
Lavey, R. S. (2003) · Medical radiology · doi:10.1007/978-3-642-56411-6_27
Jin, H. Y., Lee, J. A., Park, M., Lee, D.-E., & Park, H. J. (2023) · Figshare · doi:10.6084/m9.figshare.22619677
Management of the interaction between the multiple pituitary hormone deficiencies
Feldt‐Rasmussen, U., Effraimidis, G., Rasmussen, Å. K., & Klose, M. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00392-7
Adrenal Emergencies in Critically Ill Cancer Patients
Popovich, J. J., & Enfield, K. B. (2026) · Springer eBooks · doi:10.1007/978-3-319-74698-2_81-2
Sabet, K., Lovell, H., & Fonseca, A. (2026) · Child s Nervous System · doi:10.1007/s00381-026-07376-9
Chen, L. R., Perry, M. B., Salomon‐Estebanez, M., Livesey, D., Martin, G. P., & Higham, C. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-125247
Rodríguez, E. F. (2012) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Holmer, H. (2007) · Lund University Publications (Lund University)
Störungen der Pubertätsentwicklung und der Fertilität
Denzer, C., Hauffa, B. P., Rohrer, T. R., Brämswig, H. J., & Dörr, H. G. (2015) · Monatsschrift Kinderheilkunde · doi:10.1007/s00112-014-3173-y
Radiotherapy for Pituitary Adenomas
Grosu, A., Köcher, M., Voges, J., Müller, R., & Molls, M. (2003) · Medical radiology · doi:10.1007/978-3-642-56411-6_9
Management of Acute and Late Endocrine Effects Following Childhood Cancer Treatment
Brodsky, J. L., & Grimberg, A. (2013) · Humana Press eBooks · doi:10.1007/978-1-60761-395-4_10
Metadata
- Authors
- Constine, L. S., Woolf, P. D., Cann, D., Mick, G., McCormick, K., Raubertas, R. F., & Rubin, P.
- Affiliations
- University of Rochester Medicine (US)
- State University of New York (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1993-01-14
- Volume
- 328
- Issue
- 2
- Pages
- 87-94
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2329522359
- Cited by
- 619
- References
- 38
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 9 · 2023: 12 · 2022: 22 · 2021: 15 · 2020: 16 · 2019: 32 · 2018: 28 · 2017: 17 · 2016: 21 · 2015: 21 · 2014: 23 · 2013: 16 · 2012: 24
- FWCI
- 11.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (RR-00044, M01RR000044)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Effects of Radiation Exposure
- Keywords
- hypothalamic-pituitary dysfunction, cranial irradiation, brain tumors, hypothyroidism, hypogonadism, hyperprolactinemia, adrenal insufficiency, growth hormone deficiency, metyrapone test, pituitary stimulation test, long-term radiation effects, children and adolescents
- MeSH terms
- Adolescent, Adrenal Glands, Adult, Aged, Brain Neoplasms, Child, Female, Gonads, Humans, Hyperprolactinemia, Hypogonadism, Hypothalamus, Hypothyroidism, Male, Middle Aged, Pituitary Gland, Radiation Dosage, Radiotherapy, Thyroid Gland, Thyroid Hormones
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