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Horm Metab Res 2019; 51(03): 178-185
DOI: 10.1055/a-0850-9448
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Quality of Life but not Cognition is Impacted by Radiotherapy in Patients with Non-Functioning Pituitary Adenoma

Genevieve Crouzeix
1   Department of Endocrinology, University Hospital of Brest, Brest Cedex, France
,
Rémy Morello
2   Department of Biostatistics and Clinical Research, Caen Cedex, France
,
Juliette Thariat
3   Department of Radiation Oncology, Baclesse Cancer Center, Caen Cedex, France
,
Julia Morera
4   Department of Endocrinology and Diabetology, University Hospital of Caen, Caen Cedex, France
,
Michael Joubert
4   Department of Endocrinology and Diabetology, University Hospital of Caen, Caen Cedex, France
5   University of Caen, Medical School, Caen, France
,
Yves Reznik
4   Department of Endocrinology and Diabetology, University Hospital of Caen, Caen Cedex, France
5   University of Caen, Medical School, Caen, France
› Author Affiliations
Further Information

Publication History

received 15 September 2018

accepted 24 January 2019

Publication Date:
12 March 2019 (online)

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Abstract

Non-functioning pituitary adenomas (NFPA) are benign neoplasms that are first treated by surgery and secondary radiation therapy in case of residual tumor or regrowth. The consequences of surgery and radiotherapy are still debated. The objective of the work was to assess the impact of surgery, radiotherapy (RT) and pituitary deficiencies on long term health-related quality of life (QoL) and cognitive function among NFPA patients. Forty-six NFPA patients were studied after 9.6±7.5 years follow-up using: i) the MoCA questionnaire to detect mild cognitive disabilities, ii) the McNair and Kahn scale to assess perceived cognitive impairment, iii) the HADS questionnaire to score anxiety and depression, and iv) the SF-36 and QLS-H questionnaires to assess QoL. All NFPA patients had surgery and 54% patients had radiation therapy (RT+). The MoCA score was abnormal in 41% NFPA patients. Neither the type of surgery nor radiotherapy influenced the prevalence of cognitive disabilities. The depression score was higher in RT+than RT– patients. Overall, no alteration in SF-36 and QLS-H QoL scales were observed in NFPA patients when compared with the French reference population. Among NFPA patients, mental composite score, general health and vitality scores were altered in RT+compared to RT– patients. The presence of multiple pituitary axis deficiencies worsened general health and vitality scale scoring. Consistent follow-up had a beneficial impact on psycho-emotional dimensions of health. Surgery and radiotherapy had no adverse effects on cognitive functions, however, QoL was altered in RT+patients. These latter alterations may be partly related to pituitary hormone deficiencies.

Key words

radiotherapy - surgery - pituitary adenoma - hypopituitarism - cognitive function - quality of life
 

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