title: Final height and insulin-like growth factor-1 in children with medulloblastoma treated with growth hormone.
abstract: OBJECTIVE
  Medulloblastoma is a highly malignant childhood brain tumor. Survival from medulloblastoma is increasing. This study was performed to examine growth outcomes, insulin-like growth factor-1(IGF-1), and response to growth hormone (GH) treatment in children with medulloblastoma.
  
  
  METHODS
  Retrospective analysis of 34 children treated with GH for medulloblastoma was performed. We evaluated serum IGF-1 and insulin-like growth factor binding protein-3 concentrations. Further, we examined growth status and changes with GH treatment according to treatment modality.
  
  
  RESULTS
  GH deficiency was observed in 28 patients (82 %). The initial height at the start of GH treatment was -2.35 ± -1.53 standard deviation score (SDS) and increased to -1.85 ± -1.28 SDS by 1 year, -1.64 ± -1.46 SDS by 2 years, and -1.42 ± -1.49 SDS by 3 years after GH treatment. The final height was -1.54 ± -1.06 SDS. Gender, surgical method, tumor location, tumor size, and type of radiation did not correlate with height gain. A younger age at the initiation of GH treatment correlated with height gain. The initial serum IGF-1 concentration was -1.73 ± -0.42 and increased significantly to -0.74 ± -0.21 SDS by 1 year after GH treatment. The serum IGF-1 SDS increment correlated significantly with height gain.
  
  
  CONCLUSIONS
  Beginning GH treatment at a younger age was an important prognostic factor for growth outcome. Serum IGF-1 increment correlated with height gain during GH treatment. Thus, early GH treatment and analysis of serum IGF-1 might be helpful for improving final height or growth outcome.
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Hyun Wook
authors.initials: HW
authors.lastname: Chae
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Park
authors.forename: Dong Seok
authors.initials: DS
authors.lastname: Kim
authors.forename: Ah Reum
authors.initials: AR
authors.lastname: Kwon
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Kim
authors.forename: Duk Hee
authors.initials: DH
authors.lastname: Kim
mesh_terms: D001827:Body Height / Q000187:drug effects*; D002528:Cerebellar Neoplasms / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006130:Growth Disorders / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis / Q000378:metabolism*; D008297:Male; D008527:Medulloblastoma / Q000628:therapy*; D019635:Neurosurgical Procedures / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I