The effect of long-term glucocorticoid therapy on pituitary-adrenal responses to exogenous corticotropin-releasing hormone

Article Abstract:

Corticotropin-releasing hormone (CRF) can be used to test the function of the pituitary and adrenal glands in patients receiving long-term corticosteroid therapy. Corticosteroids can suppress the pituitary and adrenals, and measurement of cortisol - the major corticosteroid produced by the adrenal glands - in the patient's blood may not accurately detect this suppression. In individuals with normal pituitary and adrenal function, CRF stimulates the pituitary to produce ACTH, which stimulates the adrenals to produce cortisol. This response occurred in 103 patients receiving corticosteroids; in 133 patients, the response was blunted, and 43 patients had no response to CRF. Forty-six percent of the patients with normal blood cortisol levels had a blunted response to CRF. The use of CRF to assess pituitary-adrenal function in corticosteroid-treated patients may be as accurate as - and safer than - the insulin hypoglycemia test.

Usage, Physiological aspects, Corticosteroids, Adrenocortical hormones, Corticotropin releasing hormone, Corticotropin-releasing hormone, Pituitary-adrenal function tests

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Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer

Article Abstract:

Pelvic radiation treatment combined with chemotherapy appears to be more effective in treating cervical cancer than radiation treatment alone. Researchers randomly assigned 386 women with cervical cancer to receive radiation to the pelvis or pelvic radiation plus chemotherapy with cisplatin and fluorouracil. Five-year survival rates were 73% in the group that received radiotherapy and chemotherapy compared to 58% in the group receiving radiotherapy alone. Women treated with radiotherapy alone were more likely to develop metastatic cancer. The frequency of side effects was similar in both groups.

Care and treatment, Cervical cancer, Radiotherapy, Chemotherapy

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