title: Growth hormone and segmental growth in survivors of head and neck embryonal rhabdomyosarcoma.
abstract: OBJECTIVE
  To assess the impact of treatment for embryonal rhabdomyosarcoma on spinal growth and limb length and examine the response of these parameters to growth hormone (GH) treatment.
  
  
  METHODS
  We conducted a retrospective case note review of 17 survivors of head and neck rhabdomyosarcoma followed up at a single institution. All children had been treated with chemotherapy and local radiotherapy. Growth velocity, height, sitting height, and subischial limb length SDS scores were analysed.
  
  
  RESULTS
  Growth failure secondary to isolated GH deficiency (GHD) developed in 7/17 patients. GHD occurred at a median (range) of 3.4 (1.3-9.9) years after radiotherapy tumour doses of 46 (40-50) Gy. Growth velocity, height, and subischial limb length SDS were significantly reduced in the GHD group and improved with GH therapy.
  
  
  CONCLUSIONS
  GH treatment resulted in a significant improvement in sitting height SDS. We discuss the unexpected improvement in spinal growth in survivors with GHD.
authors.affiliation: Department of Endocrinology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Katz
authors.forename: P
authors.initials: P
authors.lastname: Bareille
authors.forename: G
authors.initials: G
authors.lastname: Levitt
authors.forename: R
authors.initials: R
authors.lastname: Stanhope
mesh_terms: D001827:Body Height / Q000187:drug effects / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D013006:Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007223:Infant; D007867:Leg Bones / Q000254:growth & development / Q000528:radiation effects; D008297:Male; D012189:Retrospective Studies; D018233:Rhabdomyosarcoma, Embryonal / Q000532:radiotherapy*; D013131:Spine / Q000254:growth & development / Q000528:radiation effects; D017741:Survivors
chemical_list: D013006:Growth Hormone