Évaluation de la toxicité hypophysaire après irradiation de chondrosarcomes de la base du crâne chez l’adulte

Abstract : Pituitary dysfunction is a late-delayed side effect of cranial radiotherapy. The object of this study was to evaluate radiation induced pituitary toxicity of proton beam therapy in a cohort of adult chondrosarcoma patients. The files of 113 patients were reviewed retrospectively. Mean age at the beginning of radiotherapy was 43 years old (18 to 76). Mean dose delivered to the tumor was 67 Gy and mean dose delivered to the pituitary gland was 59 Gy. Mean post radiotherapy follow up time was 7 years. 78 patients (69 %) presented with a pituitary dysfunction including hyperprolactinemia (40 %), thyrotrophic insufficiency (36 %), corticotropic insufficiency (31 %) and gonadotropic insufficiency (25 %). Pituitary anomalies were developed in more or less 4 years and no significant differences were shown between the axes for this delay. No cardiovascular risk factor was associated with pituitary insufficiency. Pituitary toxicity of radiotherapy is frequent after 4 years in this study. The high prevalence of hyperprolactinemia on diagnosis pinpoints a possible hypothalamic origin of post radiotherapy pituitary insufficiency. A prospective follow up is necessary to complete these observations.
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Master Thesis
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Suzanne Laroche. Évaluation de la toxicité hypophysaire après irradiation de chondrosarcomes de la base du crâne chez l’adulte. Médecine humaine et pathologie. 2016. ⟨dumas-01621498⟩

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