Hypothyroidism among patients with glioblastoma multiforme

Morteza Faghih-Jouybari; Soheil Naderi; Sara Mashayekhi; Tahereh Padeganeh; Sina Abdollahzade

doi:10.18502/ijnl.v17i3.375

Morteza Faghih-Jouybari Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Soheil Naderi Department of Neurosurgery, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
Sara Mashayekhi Department of Neurosurgery, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
Tahereh Padeganeh Department of Maxillofacial Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Sina Abdollahzade Department of Neurosurgery, Rajaayi Hospital, Qazvin University of Medical Sciences, Qazvin, Iran

DOI: https://doi.org/10.18502/ijnl.v17i3.375

Keywords: Glioblastoma Multiforme, Hypothyroidism, cranial irradiation

Abstract

Background: Patients with glioblastoma multiforme (GBM) are prone to various metabolic changes such as hypothyroidism. The present study was planned to assess the frequency of hypothyroidism in these patients.

Methods: Fifty-two patients with GBM were included. All of them had been treated by tumor resection followed by cranial irradiation. Thyroid function was assessed by measurement of serum thyroid stimulating hormone (TSH), free thyroxin (FT4), and free triiodothyronine (FT3).

Results: There were 33 men and 19 women. The average age was 52.4 ± 12.8 years. Among these,
32 (61%) had normal thyroid function test, whereas 4 (8%) had subclinical hypothyroidism, 5 (10%) had overt primary hypothyroidism, and 11 (21%) had secondary hypothyroidism. Sixteen patients (31%) needed thyroid hormone replacement therapy.

Conclusion: Hypothyroidism is relatively prevalent in patients with treated GBM. Regular thyroid function test is advised to aid the introduction of appropriate hormone replacement therapy.

References

1. Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet 2017; 390(10101): 1550-62.
2. Merchant TE, Conklin HM, Wu S, Lustig RH, Xiong X. Late effects of conformal radiation therapy for pediatric patients with low-grade glioma: Prospective evaluation of cognitive, endocrine, and hearing deficits. J Clin Oncol 2009; 27(22): 3691-7.
3. Chemaitilly W, Li Z, Huang S, Ness KK, Clark KL, Green DM, et al. Anterior hypopituitarism in adult survivors of childhood cancers treated with cranial radiotherapy: A report from the St Jude Lifetime Cohort study. J Clin Oncol 2015; 33(5): 492-500.
4. Chieng PU, Huang TS, Chang CC, Chong PN, Tien RD, Su CT. Reduced
hypothalamic blood flow after radiation treatment of nasopharyngeal cancer: SPECT studies in 34 patients. AJNR Am J Neuroradiol 1991; 12(4): 661-5.
5. Kyriakakis N, Lynch J, Orme SM, Gerrard G, Hatfield P, Loughrey C, et al. Pituitary dysfunction following cranial radiotherapy for adult-onset nonpituitary brain tumours. Clin Endocrinol (Oxf) 2016; 84(3): 372-9.
6. Appelman-Dijkstra NM, Kokshoorn NE, Dekkers OM, Neelis KJ, Biermasz NR, Romijn JA, et al. Pituitary dysfunction in adult patients after cranial radiotherapy: Systematic review and meta-analysis. J Clin Endocrinol Metab 2011; 96(8): 2330-40.
7. Ghigo E, Masel B, Aimaretti G, Leon-Carrion J, Casanueva FF, Dominguez-Morales MR, et al. Consensus guidelines
on screening for hypopituitarism following traumatic brain injury. Brain Inj 2005; 19(9): 711-24.
8. Schneider HJ, Rovere S, Corneli G, Croce CG, Gasco V, Ruda R, et al. Endocrine dysfunction in patients operated on for non-pituitary intracranial tumors. Eur J Endocrinol 2006; 155(4): 559-66.
9. Pekic S, Popovic V. Alternative causes of hypopituitarism: Traumatic brain injury, cranial irradiation, and infections. Handb Clin Neurol 2014; 124: 271-90.
10. Bhandare N, Kennedy L, Malyapa RS, Morris CG, Mendenhall WM. Primary and central hypothyroidism after radiotherapy for head-and-neck tumors. Int J Radiat Oncol Biol Phys 2007; 68(4): 1131-9.