Endocrine Outcome in Long-Term Survivors of Childhood Brain Tumors

Abstract

Aim: To evaluate the rates of endocrine abnormalities in survivors of childhood brain tumors and identify risk factors. Methods: The medical charts of patients were reviewed for background, disease-related and treatment-related data. Endocrine dysfunction was determined by clinical and laboratory evaluation. Results: The study group included 114 patients with a mean age of 15.57 ± 5.93 years. Mean age at brain tumor diagnosis was 7.07 ± 5.42 years, and mean follow-up was 12.8 ± 6.25 years. Fifty-seven patients (50%) had an endocrine abnormality. The occurrence of several endocrine abnormalities was significantly associated with cranial irradiation and age <16 years at tumor diagnosis. The presence of growth hormone deficiency (n = 40) was associated with cranial or spinal irradiation, younger age and prepubertal stage at tumor diagnosis; the presence of hypogonadotropic hypogonadism (n = 9) was associated with prepubertal stage at diagnosis, and hypothyroidism (n = 23) was associated with cranial irradiation. Hypocortisolism was diagnosed in 9 patients, short stature in 20 patients and obesity in 8 male patients. Patients with early puberty (n = 19) and an abnormal lipid profile (n = 15) were significantly younger at tumor diagnosis than patients without these disorders. Conclusions: Childhood brain tumor survivors are at increased risk of late endocrine effects, particularly those treated with cranial radiation and diagnosed at a younger age. The frequency of hormonal deficits increases with time, warranting lifelong surveillance.

Endocrine health conditions in adult survivors of childhood cancer: the need for specialized adult-focused follow-up clinics

“…This result, which agrees with previous reports 14 Figure 1 Prevalence of endocrine disorders at the last follow-up visit, by gender. (3,20,21), is doubtless alarming especially in a population that -in many countries -still does not receive an adequate follow-up. Anyway, it should be considered that about 50% of our patients were treated before 1995.…”

Water and Electrolyte Disorders at Long-Term Post-Treatment Follow-Up in Paediatric Patients with Suprasellar Tumours Include Unexpected Persistent Cerebral Salt-Wasting Syndrome

“…Brain tumours are the most frequent solid tumours during childhood and adolescence [1,2] and also the principal cause of mortality from childhood cancer [2,3]. …”

“…Tumours which originate in or near the sella turcica, or those with extensions towards this area, may produce signs of hormonal disorders, including anterior and posterior pituitary deficiencies, prior to diagnosis [2,3,4] or as a consequence of antitumour treatment [1,5]. …”

Central diabetes insipidus and adipsia due to astrocytoma: diagnosis and management

“…Cranial irradiation predisposes to injury of the anterior pituitary but spares the neurohypophysis, even in follow up as long as 10-12 years following radiation [19,20]. In a series of 26 patients who received cranial irradiation for extrasellar tumors, none developed diabetes insipidus, although a variety of anterior pituitary disorders were observed [21].…”