The impact of cranial irradiation (CIR) and chemotherapy on the @entity774 was assessed in a population-based follow-up study of @entity1 treated for @entity1313 not directly involving the @entity4611 . HPA function was evaluated and compared with that in healthy controls (n = 17), measuring basal @entity701 and the peak @entity701 response to an insulin tolerance test (ITT) and an @entity4545 test(.) The @entity701 cut-off level was 500 nmol/liter. The @entity10204 ( @entity10204 ) of radiotherapy was determined for the @entity4611 region and spine and was expressed in Gray units, as @entity10204 gives a means of expressing the biological effects of different dosage schedules in a uniform way. Seventy-three @entity1 (46 males and 27 females), less than 15 yr of age when diagnosed during 1970-1997 in the Eastern part of Denmark, were included. The median age at time of radiotherapy was 8.4 yr (range, 0.8-14.9). The median length of follow-up was 15 yr (range, 2-29). Fourteen @entity1 (19%) had basal @entity701 levels below 500 nmol/liter and did not respond with a peak @entity701 above the cut-off level to either an @entity4545 test (30 or 60 min) or an ITT, and thus, they had insufficiency of the @entity2270 . Even though a peak @entity701 above 500 nmol/liter was reached in the rest of the cohort (n = 59) after either an @entity4545 test (30 or 60 min) or an ITT, they had significantly lower peak @entity701 levels compared with controls (P = 0.0099). Thirteen @entity1 failed the @entity4545 test (30 min), but passed the @entity4545 test (60 min), implying a risk of misinterpreting the @entity701 capacity of the @entity1 if only the @entity4545 test (30 min) is obtained. The basal @entity701 levels and the @entity701 levels in the @entity4545 test (30 min) and the @entity4545 test (60 min) were significantly lower in the @entity1 group compared with controls. There was a significant correlation between the peak @entity701 after the ITT compared with the peak @entity701 after the @entity4545 test (30 or 60 min; r(s) = 0.56; P = 0.0006), but 48% failed the ITT, and there was discordance in 10 of 33 (30%) @entity1 who passed the @entity4545 but failed the ITT, indicating the recommendation of continuous use of the ITT as the gold standard for evaluation of the @entity2270 . Stepwise backward multiple linear regression analysis showed that the best-fit model to predict the peak @entity701 level after an ITT included @entity10204 (P = 0.04) and length of follow-up (P = 0.06). In contrast, age at @entity138 , chemotherapy, @entity10204 to the spine, and gender were not included in the model. In conclusion, these data suggest that CIR for a @entity1313 may affect the @entity2270 , resulting in secondary @entity1887 , whereas adjuvant chemotherapy does not seem to add to the deleterious effect of CIR. We recommend life-long surveillance of the @entity2270 and performing regular ITTs.

Assessment of the @entity4611 -adrenal axis in XXXX treated with radiotherapy and chemotherapy for @entity1313 .

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient'] @entity4545 :: ('5443', 'Gene') :: ['ACTH'] @entity1313 :: ('MESH:D001932', 'Disease') :: ['childhood brain tumor'] @entity138 :: ('MESH:C563738', 'Disease') :: ['RT'] @entity1887 :: ('MESH:D000309', 'Disease') :: ['adrenal insufficiency'] @entity10204 :: ('MESH:D021081', 'Disease') :: ['biological effective dose', 'BED'] @entity4611 :: ('MESH:D010900', 'Disease') :: ['HP axis', 'HP'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol'] @entity2270 :: ('MESH:C566610', 'Disease') :: ['HPA axis'] @entity774 :: ('MESH:D000312', 'Disease') :: ['hypothalamo-pituitary (HP)-adrenal (HPA) axis']
@entity1 :: (9606,Species) :: ['patients']
