The long-term effects of megavoltage radiotherapy as sole or combined therapy for large XXXX : studies with high definition computerized tomography.

@entity1 @entity2847 @entity4089 @entity2013 @entity5 @entity6161 @entity4776 @entity4090 @entity4611 @entity1866 @entity51 @entity21696
The long-term sequelae of external pituitary irradiation alone or in combination with surgery and/or @entity2847 therapy have been studied in 14 @entity1 with large @entity2013 over an observation period of 6-22 years (mean 13 years). @entity21696 was abolished in four of the five females with this symptom, but @entity1866 persisted in five of six @entity1 . Sexual function was normal without sex hormone replacement in only one of the eight males after treatment. @entity51 were abolished or improved by treatment in all 9 @entity1 with this presentation. Serum @entity4090 levels declined after treatment (P less than 0.001) and fell to within the normal range off @entity2847 therapy in six of the 14 @entity1 at a mean of 9 years (range 5-17 years) after radiotherapy. All @entity1 had @entity4611 of some degree at reassessment, and 13 required replacement treatment. Serial skull radiographs revealed remineralization of the fossa floor in five @entity1 and a decrease in fossa size in three. All five @entity1 who did not also have surgery had evidence of @entity5 shrinkage without @entity2847 treatment (on CT scan or @entity6161 cisternography). Fourth generation CT scans on completion of the study revealed a decrease in @entity5 mass in all @entity1 , with varying degrees of @entity4776 in 13 and a @entity5 in the remaining one. @entity5 was demonstrated in 10 @entity1 , three of whom had normal serum @entity4090 levels, while one @entity1 without visible @entity5 had persistent @entity4089 . Radiotherapy, alone or in combination with surgery and @entity2847 , effectively decreases @entity4090 secretion and @entity5 size in @entity1 with large @entity2013 at the expense of other anterior pituitary function. Circulating @entity4090 levels are a poor marker of @entity5 volume.
