CONTEXT: It is well recognised there is a high prevalence of pituitary dysfunction in childhood brain tumours survivors who are treated with radiotherapy. In contrast, the potential for survivors of brain tumours arising in adulthood to develop radiotherapy-induced hypopituitarism may be underestimated. The aim of this systematic review and meta-analysis is to determine the pooled prevalence of radiotherapy-induced hypopituitarism in survivors of primary non-pituitary brain tumours arising in adulthood. DESIGN: A systematic literature search of five databases was performed. Two reviewers independently screened potential articles and then extracted data from accepted studies. A random effects meta-analysis was performed to assess the pooled prevalence of radiotherapy-induced hypopituitarism for each hormone axis. Forest plots were created to graphically represent these estimates with 95% confidence intervals (CI). Between study heterogeneity was quantified using the I RESULTS: Fourteen studies comprising a total of 580 participants were included in the review. The pooled prevalence of hypopituitarism was 48% (95% CI 36.7-59.4
I CONCLUSION: Radiotherapy-induced hypopituitarism is common, affecting almost half of survivors with a primary non-pituitary brain tumour arising in adulthood. Protocolised endocrine surveillance is essential in this cohort to identify and treat pituitary hormone deficits in a timely manner. These patients report decreased quality of life which may be due, in part, to undiagnosed pituitary dysfunction.