title: Adult height after growth hormone (GH) treatment for GH deficiency due to cranial irradiation.
abstract: BACKGROUND
  The indications and factors affecting the growth in response to treatment with growth hormone (GH) of patients with cranial irradiation-induced GH deficiency remain unclear.
  
  
  METHODS
  The adult heights of 56 patients treated with GH (0.4-0.6 U/kg/week) as daily sc injections were analysed. They had been given 18 or 24 Grays (Gy) cranial irradiation for leukemia (group 1, 26 cases), 50 +/- 1 Gy for various tumors (group 2, 13 cases), 46 +/- 1 Gy for retinoblastoma (group 3, 8 cases), or 34 +/- 2 Gy with spinal irradiation for medulloblastoma (group 4, 9 cases). Twenty- five of these 56 patients had early puberty and were also treated with gonadotropin-releasing hormone (GnRH) analog.
  
  
  RESULTS
  The standing (-1.0 +/- 0.2 in group 1, -0.7 +/- 0.3 in group 2, -1.1 +/- 0.3 in group 3, and -2.0 +/- 0.4 SD in group 4) and sitting (-1.8 +/- 0.2 in group 1, -0.4 +/- 0.4 in group 2, -1.2 +/- 0.4 in group 3, and -3. 4 +/-0.4 SD in group 4) adult heights were shor ter (P < 0.05 for standing and P < 0.001 for sitting heights) for group 4 than for each of the other groups. Of the 47 patients given cranial (and not craniospinal) irradiation, sitting adult height was shorter (P = 0. 02) and the difference between standing adult and target heights greater (P = 0.03) in those patients in whom puberty occurred at a normal age than in those treated with GnRH analog. Conclusion. The incomplete catch-up of growth seems to be mainly due to the reduction in sitting height of patients given spinal irradiation and in whom puberty occurred at a normal age. This suggests that GnRH analog treatment should be more widely used to treat children with early and/or rapidly progressing puberty after cranial irradiation.
authors.affiliation: Pediatric Endocrinology Department, Université René Descartes and Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Adan
authors.forename: C
authors.initials: C
authors.lastname: Sainte-Rose
authors.forename: J C
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: J M
authors.initials: JM
authors.lastname: Zucker
authors.forename: C
authors.initials: C
authors.lastname: Kalifa
authors.forename: R
authors.initials: R
authors.lastname: Brauner
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height / Q000187:drug effects* / Q000528:radiation effects; D002648:Child; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006128:Growth / Q000187:drug effects / Q000528:radiation effects; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000532:radiotherapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000532:radiotherapy; D011627:Puberty; D012175:Retinoblastoma / Q000532:radiotherapy; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone