Use of endocrinological and neurological medication among 5-year survivors of young onset brain tumors.
The burden of late-effects for young onset brain tumor (BT) survivors needs more careful evaluation. Our aim was to assess the need for endocrinological and neurological medication among this specific group. We identified 5-year survivors diagnosed at the age of 0-24 years between 1988 and 2004 from the Finnish Cancer Registry (N = 602). Data on endocrinological and neurological drug purchases were collected from the Social Insurance Institution of Finland. Five years after diagnosis the most commonly purchased drugs had been: antiepileptics (44.8 %), systemic hydrocortisone (18.3 %), female sex hormones (17.6 %), thyroid hormones (11.2 %), and growth hormone (10.0 %). The survivors showed an increased hazard ratio (HR) for a need for new types of drugs still 5 years after diagnosis. Thyroid hormones (HR 10.6, 95 % CI 5.1-21.4), estrogens (HR 8.0, 95 % CI 2.1-25.7), and antiepileptics (HR 6.3, 95 % CI 3.4-11.2) were bought with high frequencies. Irradiation increased the hazard for drug-purchases other than antiepileptics. Cumulative incidence of purchases of estrogens or androgens increased still 15 years after diagnosis. The cumulative incidence of purchasing thyroid hormones and antiepileptics showed continuous increase for the youngest group, whereas survivors diagnosed at 15-24 years of age reached stable level before 15 years from diagnosis. The need for new medication continued more than a decade after BT diagnosis. Especially the need for new thyroid or sex hormone medication among childhood BT survivors may emerge long after diagnosis.
Department of Pediatrics, Turku University Hospital, PO Box 52, 20521, Turku, Finland. mestor@utu.fi.
Mirja Erika
ME
Gunn
Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, PO Box 52, 20521, Turku, Finland.
Tuire
T
Lähdesmäki
Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland.|School of Health Sciences, University of Tampere, 33014, Tampere, Finland.
Nea
N
Malila
Department of Pediatrics, Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland.
Mikko
M
Arola
Department of Pediatrics, Turku University Hospital, PO Box 52, 20521, Turku, Finland.
Marika
M
Grönroos
Clinical Research Centre, Turku University Hospital, PO Box 52, Turku, Finland.
Jaakko
J
Matomäki
Department of Pediatrics, Turku University Hospital, PO Box 52, 20521, Turku, Finland.
Päivi Maria
PM
Lähteenmäki
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D000073116:Cancer Survivors / Q000706:statistics & numerical data; D002491:Central Nervous System Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D012042:Registries; D055815:Young Adult
D002491:Central Nervous System Agents; D006728:Hormones
Brain tumor; Cancer; Late-effect; Medication; Survivor