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Radiotherapy in paediatric Cushing's disease: efficacy and long term follow up of pituitary function.
MedLine Citation:
PMID:  20411340     Owner:  NLM     Status:  In-Process    
Pituitary radiotherapy (RT) is an effective second-line treatment for paediatric Cushing's disease (CD). We report long-term efficacy and anterior pituitary function in a cohort of paediatric CD patients treated with RT. Between 1988 and 2008, from our cohort of 48 paediatric CD patients, eight paediatric CD patients (5 males and 3 females) underwent second-line pituitary RT (45 Gy in 25 fractions), following unsuccessful transsphenoidal surgery. Out of eight whose long term follow up is available, four patients were cured by RT. Minimum follow up of 2 years is available for all patients. Four patients achieved cure after RT. Two patients were not cured even after follow up of 60 and 132 months, respectively. Out of four uncured patients, two of them had suppressible low dose dexamethasone cortisol with altered circadian rhythm suggesting possibility of response in near future with follow up of just 26 months. Five patients were hypogonadal and one patient was hypothyroid. All patients were below their target height at the time of last follow up. None of the patients had posterior pituitary dysfunction. This series of patients illustrates the efficacy and long-term follow up of pituitary function in children with CD treated with RT. This study also emphasizes the need of growth hormone statues assessment and timely intervention.
Shrikrishna V Acharya; Raju A Gopal; Joe Goerge; Padma S Menon; Tushar R Bandgar; Nalini S Shah
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pituitary     Volume:  13     ISSN:  1573-7403     ISO Abbreviation:  Pituitary     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9814578     Medline TA:  Pituitary     Country:  United States    
Other Details:
Languages:  eng     Pagination:  293-7     Citation Subset:  IM    
Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, 12 Maharashtra, India.
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