THE EFFECTS OF ROENTGEN IRRADIATION ON ADRENAL CORTICAL FUNCTION IN MAN
Nine cases of patients with testicular tumors receiving therapeutic doses of roentgen rays to the region of the adrenal glands are presented. The 17- ketosteroid and 17-hydroxycorticosteroid excretion studies were carried out prior to the initiation of radiation therapy, during therapy, and for a follow-up period. Adrenal steroidogenesis was evaluated by the response of the adrenal to stimulation with 40 units of ACTH administered intravenously over a 10-hr period on one day, or on two successive days. The data indicate a variable degree of enhancement of adrenal cortical steroidogenesis during or immediately following radiation therapy to the adrenal glands in the majority of patients, presumably reflecting the general adaptation syndrome to stress. Most patients acquired a mild degree of adrenal cortical impairment secondary to such irradiation. The data indicate that the administration of more than 2000 r tissue dose to the adrenal glands produces increased adrenal cortical steroidogenesis during irradiation in response to the one-day intravenous ACTH stimulation test. Less than 2000 r tissue dose produces no impairment or stimulation of adrenal steroidogenesis or reserve as measured by one- or two-day intravenous ACTH stimulation. Administration of 2000 to 3000 r tissue dose produces a transient stimulation with a simultaneous loss of adrenal contical reserve as shown by intravenous ACTH administration on two consecutive days. More than 3000 r tissue dose results in transient stimulation followed by subsequent adrenocortical impairment as manifested by stimulation by one day of intravenous ACTH administration. Following 3500 r tumor dose, the adrenal glands still appear to have a normal amount of steroidogenesis under nonstress conditions, but their ability to respond to stress is markedly limited. The data on patients receiving roentgen radiation through portals including the adrenal glands and through other portals suggest that the enhancement and impairment observed are both due to direct irradiation of the adrenal glands, but generalized secondary systemic toxicity may play a role. One patient who died showed no evidence of functional adrenal cortical impairment after 3500 r tumor dose to the adrenal glands and 3000 r tumor dose to the mediastinum. At autopsy, no histologic changes of the adrenal cortex were found. Study of the adrenal glands of other patients receiving similar doses of therapeutic roentgen radiation to the adrenal glands likewise failed to reveal any characteristic or significant histologic changes. (auth)
- Research Organization:
- Letterman Army Hospital, San Francisco; Sixth U.S. Army Medical Lab., Fort Baker, Calif.
- NSA Number:
- NSA-15-007202
- OSTI ID:
- 4116331
- Journal Information:
- Am. J. Roentgenol., Radium Therapy Nuclear Med., Journal Name: Am. J. Roentgenol., Radium Therapy Nuclear Med. Vol. Vol: 85
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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