Immune checkpoint inhibitors (ICIs) have revolutionized oncology, providing a groundbreaking therapeutic option for patients with various advanced-stage cancers. While these treatments can significantly extend survival, they also carry a substantial risk of immune-related adverse events, among which hypophysitis is particularly detrimental to endocrine function. This narrative review synthesizes current knowledge on the pathogenesis, clinical features, diagnosis, and management of ICI-induced hypophysitis (IH) based on an in-depth analysis of the recent literature and clinical trials. The diagnosis of IH presents unique challenges due to its overlap with systemic symptoms commonly associated with the underlying malignancy. These symptoms can include asthenia, anorexia, headache, vomiting, weight loss, hypotension, dizziness, decreased libido, and visual disturbances. Diagnostic evaluation typically combines clinical assessment, hormonal profiling, and findings from magnetic resonance imaging (MRI). Effective management of IH requires a personalized, multidisciplinary approach, focusing on hormone replacement therapy and vigilant monitoring. Long-term care depends on the severity of hypophysitis, and the specific hormonal axes involved. This review aims to enhance awareness of the critical aspects of recognizing and managing IH, underscoring the importance of early diagnosis and timely intervention to reduce its long-term effects on patient quality of life.
免疫检查点抑制剂（ICIs）已彻底改变肿瘤学领域，为多种晚期癌症患者提供了突破性的治疗选择。尽管这些治疗能显著延长生存期，但也伴随着较高的免疫相关不良事件风险，其中垂体炎对内分泌功能的损害尤为严重。本文基于对近期文献及临床试验的深入分析，系统综述了ICI诱导垂体炎（IH）的发病机制、临床特征、诊断及管理策略。由于IH症状常与恶性肿瘤的全身性表现重叠，其诊断面临独特挑战，常见症状包括乏力、厌食、头痛、呕吐、体重减轻、低血压、头晕、性欲减退及视力障碍。诊断评估通常需结合临床检查、激素水平检测及磁共振成像结果。IH的有效管理需要个体化、多学科协作的治疗策略，重点关注激素替代治疗与密切监测。长期护理方案取决于垂体炎的严重程度及受累激素轴的具体情况。本综述旨在提高对IH识别与管理关键环节的认识，强调早期诊断与及时干预对减轻患者长期生活质量影响的重要性。
肿瘤(癌症)患者之家