Endocrine complications of pediatric brain tumors: case series and literature review.
The survival rate for childhood cancer, including brain tumors, is increasing. As a result, long-term sequelae of chemotherapy and radiotherapy are also increasing. The purpose of this study was to determine the frequency of endocrine complications of therapy for brain tumors in pediatric patients. Endocrinopathy was observed in 19 of 20 (95%) of patients with supratentorial midline tumors. Fifty-seven patients with nonmidline tumors (22 supratentorial, 35 posterior fossa) were followed for a mean of 4.6 +/- 2.4 years. Twenty-two endocrinopathies occurred in 16 patients treated as follows: one of 23 patients (0.4%) had surgery alone, zero of four (0%) had chemotherapy alone, eight of 18 (44%) had radiotherapy alone, and seven of 12 (58%) had both radiotherapy and chemotherapy. Endocrine disturbance was particularly common after craniospinal radiation (10 of 18 [55%]). Growth failure occurred in none of 23 patients who had surgery alone, in one of four patients who had chemotherapy (25%), in 11 of 18 patients who had radiotherapy (61%), in seven of 12 patients who received both radiotherapy and chemotherapy (58%), and in 12 of 18 patients who had craniospinal radiation (67%). In conclusion, endocrine and growth disturbances are uncommon with surgery alone, although they occurred in 53 and 60%, respectively, of patients treated with cranial irradiation for a brain tumor. This finding underscores the importance of routine endocrinology follow-up for all brain tumor patients receiving cranial irradiation. Literature review and endocrine surveillance recommendations are included.
Muirhead
Sarah E
SE
Division of Endocrinology, University of Ottawa, Ottawa, ON, Canada.
Hsu
Elizabeth
E
Grimard
Laval
L
Keene
Daniel
D
D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects; D003399:Craniotomy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D008297:Male; D009384:Paraneoplastic Endocrine Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate
D019382:Human Growth Hormone