Turkish Archives of Pediatrics
Original Article

Long-Term Endocrinologic Follow-Up of Children with Brain Tumors and Comparison of Growth Hormone Therapy Outcomes: A SingleCenter Experience

1.

Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey

2.

Department of Pediatric Endocrinology, Near East University Faculty of Medicine, Nicosia, Turkish Republic of Northern Cyprus

3.

Department of Pediatric Hematology-Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey

4.

Department of Radiation Oncology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey

5.

Department of Pediatric Endocrinology, University of Kyrenia Faculty of Medicine, Kyrenia, Turkish Republic of Northern Cyprus

Turk Arch Pediatr 2023; 58: 308-313
DOI: 10.5152/TurkArchPediatr.2023.22147
Read: 897 Downloads: 262 Published: 01 May 2023

Objective: Brain tumors in childhood carry a high risk for endocrine disorders due to the direct effects of the tumor and/or surgery and radiotherapy. Somatotropes are vulnerable to pressure and radiotherapy; therefore, growth hormone deficiency is one of the most frequent abnormalities. This study aimed to evaluate endocrine disorders and recombinant growth hormone treatment outcomes in brain tumor survivors.

Materials and Methods: In this study, 65 (27 female) patients were classified into 3 groups as craniopharyngioma (n = 29), medulloblastoma (n = 17), and others (n = 19). “Others” group included astrocytoma, ependymoma, germinoma, pineoblastoma, and meningioma patients. Anthropometric data and endocrine parameters of patients and their growth outcome with/without recombinant growth hormone therapy were collected from medical records, retrospectively.

Results: Mean age at the first endocrinological evaluation was 8.7 ± 3.6 years (range: 1.0- 17.1 years). Height, weight, and body mass index standard deviation score, mean ± standard deviation (median) values were −1.7 ± 1.7 (−1.5), −0.8 ± 1.9 (−0.8), and 0.2 ± 1.5 (0.4), respectively. Hypothyroidism (central 86.9%, primary 13.1%) was detected during follow-up in 81.5% of patients. Primary hypothyroidism in medulloblastoma (29.4%) was significantly higher compared to other groups (P = .002). The frequency of hypogonadotropic hypogonadism, central adrenal insufficiency, and diabetes insipidus was significantly high in the craniopharyngioma cases.

Conclusion: In our study, endocrine disorders other than growth hormone deficiency were also frequently observed. In craniopharyngioma cases, the response to recombinant growth hormone therapy was satisfactory. However, there was no improvement in height prognosis during recombinant growth hormone therapy in medulloblastoma patients. A multidisciplinary approach to the care of these patients, referral for endocrine complications, and guidelines on when recombinant growth hormone therapy is required.

Cite this article as: Yavaş Abalı Z, Öztürk AP, Baş F, et al. Long-term endocrinologic follow-up of children with brain tumors and comparison of growth hormone therapy outcomes: A single-center experience. Turk Arch Pediatr. 2023;58(3):308-313.

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