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Alterations in hypothalamic-pituitary axis (HPA) hormones 6 months after cranial radiotherapy in adult patients with primary brain tumors outside the HPA region

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Abstract

Background

Cranial radiotherapy is a common treatment for brain tumors, but it can affect the hypothalamic-pituitary (H-P) axis and lead to hormonal disorders. This study aimed to compare serum levels of HPA hormones before and after cranial radiation.

Materials and methods

This study involved 27 adult patients who underwent brain tumor resection before the initiation of radiotherapy, and none had metastatic brain tumors. All participants had the HPA within the radiation field, and their tumors were located in brain areas outside from the HPA. Serum levels of HPA hormones were recorded both before and 6 months after cranial radiotherapy.

Results

A total of 27 adult patients, comprising 16 (59.3%) males and 11 (40.7%) females, with a mean age of 56.37 ± 11.38 years, were subjected to evaluation. Six months post-radiotherapy, serum levels of GH and TSH exhibited a significant decrease. Prior to radiotherapy, a substantial and direct correlation was observed between TSH and FSH (p = 0.005) as well as LH (p = 0.014). Additionally, a significant and direct relationship was noted between serum FSH and LH (p < 0.001) before radiotherapy. After radiotherapy, a significant and direct correlation persisted between TSH and FSH (p = 0.003) as well as LH (p = 0.005), along with a significant and direct relationship between serum FSH and LH (p < 0.001). Furthermore, a significant and direct association was identified between changes in serum GH levels and FSH (p = 0.04), as well as between serum LH and FSH (p < 0.001).

Conclusion

Reduced serum levels of HPA hormones are a significant complication of cranial radiotherapy and should be evaluated in follow-up assessments.

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Data availability

Raw data is available upon reasonable request from the first author. This article emanates from the scholarly endeavors of Ali Shahriari, the first author, and constitutes an outcome of his thesis work. In this capacity, he assumes responsibility for the meticulous curation of data, rigorous formal analysis, thorough validation processes, and ensuring the precision of all data and statistical analyses presented herein.

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Acknowledgements

 We thank all individuals for participating and appreciate the Reza Radiotherapy and Oncology Center (RROC) administrative staff and nurses for helping us collect serum samples.

Funding

We declare that this research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors conducted this study independently, and no external funding influenced the design, data collection, analysis, interpretation, or writing of the manuscript.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran

    Ali Shahriari & Amir Amirabadi

  2. Department of Neurosurgery, Ghaem Teaching Hospital, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran

    Hamid Etemadrezaie & Samira Zabihyan

  3. Innovative Medical Research Center, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran

    Amir Amirabadi

  4. Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, UT 84112, USA

    Amir Hossein Aalami

  5. Division of Nephrology and Hypertension, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA

    Amir Hossein Aalami

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  1. Ali Shahriari
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Contributions

Ali Shahriari curated and analyzed the data, validated the results, and performed statistical analyses. Hamid Etemadrezaei led the research and conceptualized the research study. Amir Amirabadi and Samira Zabihyan contributed to the development of the methodology and collection of samples. Amir Hossein Aalami drafted the original manuscript and visualized the study. All authors read and approved the final version of the manuscript.

Corresponding authors

Correspondence to Hamid Etemadrezaie or Amir Hossein Aalami.

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Conflict of interest

The authors report no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The ethics committee approved the Medical Ethics Code at the Islamic Azad University, Mashhad, Iran (IR.IAU.MSHD.REC.1399.128).

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Informed consent was obtained from all individual participants included in the study.

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Shahriari, A., Etemadrezaie, H., Zabihyan, S. et al. Alterations in hypothalamic-pituitary axis (HPA) hormones 6 months after cranial radiotherapy in adult patients with primary brain tumors outside the HPA region. Mol Biol Rep 51, 373 (2024). https://doi.org/10.1007/s11033-024-09257-3

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