Adult height after growth hormone (GH) treatment for GH deficiency due to cranial irradiation.
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.
Adan
L
L
Pediatric Endocrinology Department, Université René Descartes and Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris, France.
Sainte-Rose
C
C
Souberbielle
J C
JC
Zucker
J M
JM
Kalifa
C
C
Brauner
R
R
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
D019382:Human Growth Hormone