Growth hormone deficiency in adult survivors of childhood brain tumors treated with radiation

TY - JOUR

T1 - Growth hormone deficiency in adult survivors of childhood brain tumors treated with radiation

AU - Baunsgaard, Mette Marie

AU - Helligsoe, Anne Sophie Lind

AU - Henriksen, Louise Tram

AU - Mikkelsen, Torben Stamm

AU - Callesen, Michael

AU - Weber, Britta

AU - Hasle, Henrik

AU - Birkebæk, Niels

PY - 2023/2

Y1 - 2023/2

N2 - OBJECTIVE: Growth hormone deficiency (GHD) is the most common endocrine late effect in irradiated survivors of childhood brain tumors. We aimed to determine the prevalence of GHD in adults treated with proton or photon irradiation for a brain tumor in childhood and to detect undiagnosed GHD.DESIGN: A cross-sectional study.METHODS: We investigated GHD in five-year survivors from two health regions in Denmark treated for childhood brain tumors with cranial or craniospinal irradiation in the period 1997-2015. Medical charts were reviewed for endocrinological and other health data. Survivors without a growth hormone (GH) test at final height were invited to a GH stimulation test.RESULTS: Forty-one (22 females) survivors with a median age of 21.7 years (range 15.1 - 33.8 years) at follow up and 14.8 years (range 5.1 - 23.4 years) since diagnosis were included. Eleven were treated with proton and 30 with photon irradiation. Eighteen of 21 survivors were previously found to have GHD. Sixteen of 20 survivors with no GH test at final height were tested, 8 (50 %) had GHD. In total, 26 of 41 patients (63%) had GHD. Insulin-like growth factor-1 (IGF-1) associated poorly with the insulin tolerance test (ITT).CONCLUSION: This study identified a high prevalence of undiagnosed GHD in survivors with no GH test at final height. The results stress the importance of screening for GHD at final height in survivors of childhood brain tumors with prior exposure to cranial irradiation, irrespective of radiation modality and IGF-1.

AB - OBJECTIVE: Growth hormone deficiency (GHD) is the most common endocrine late effect in irradiated survivors of childhood brain tumors. We aimed to determine the prevalence of GHD in adults treated with proton or photon irradiation for a brain tumor in childhood and to detect undiagnosed GHD.DESIGN: A cross-sectional study.METHODS: We investigated GHD in five-year survivors from two health regions in Denmark treated for childhood brain tumors with cranial or craniospinal irradiation in the period 1997-2015. Medical charts were reviewed for endocrinological and other health data. Survivors without a growth hormone (GH) test at final height were invited to a GH stimulation test.RESULTS: Forty-one (22 females) survivors with a median age of 21.7 years (range 15.1 - 33.8 years) at follow up and 14.8 years (range 5.1 - 23.4 years) since diagnosis were included. Eleven were treated with proton and 30 with photon irradiation. Eighteen of 21 survivors were previously found to have GHD. Sixteen of 20 survivors with no GH test at final height were tested, 8 (50 %) had GHD. In total, 26 of 41 patients (63%) had GHD. Insulin-like growth factor-1 (IGF-1) associated poorly with the insulin tolerance test (ITT).CONCLUSION: This study identified a high prevalence of undiagnosed GHD in survivors with no GH test at final height. The results stress the importance of screening for GHD at final height in survivors of childhood brain tumors with prior exposure to cranial irradiation, irrespective of radiation modality and IGF-1.

U2 - 10.1530/EC-22-0365

DO - 10.1530/EC-22-0365

M3 - Journal article

C2 - 36507776

SN - 2049-3614

VL - 12

JO - Endocrine Connections

JF - Endocrine Connections

IS - 2

M1 - e220365

ER -