Growth and Endocrine Disorders Secondary to Cranial Irradiation

Rappaport, R; Brauner, Raja

doi:10.1203/00006450-198906000-00001

Cited by 181 publications

(77 citation statements)

References 51 publications

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“…In this respect our results coincide with those of other studies 2,16,19 and corroborate the theory suggested by some authors 28,29 that chemotherapy reduces IGF-I concentrations in the circula-tion. This theory is further supported by Thun-Hohenstein et al, 16 who reported that 75% of the cases of IGF-I deficit in their study were associated with patients who had received more intensive chemotherapy.…”

Section: Chemotherapy and Seeretion Of Growth Hormonesupporting

confidence: 83%

“…This theory is further supported by Thun-Hohenstein et al, 16 who reported that 75% of the cases of IGF-I deficit in their study were associated with patients who had received more intensive chemotherapy. As suggested by Rappaport and Brauner 28 and supported by Berry et al, 9 it would not be surprising to find that plasma concentrations of IGF-I decrease during chemotherapy. In our study we did not measure IGF-I levels during or immediately after treatment and thus do not know how these levels changed over time.…”

Section: Chemotherapy and Seeretion Of Growth Hormonementioning

confidence: 61%

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Growth and growth hormone secretion in children with cancer treated with chemotherapy

Román¹,

Villaizán²,

García‐Foncillas³

et al. 1997

The Journal of Pediatrics

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Objective: To evaluate the effect of chemotherapy on growth and growth hormone (GH) secretion. Methods: We analyzed growth and GH secretion in 60 children in complete remission after treatment by chemotherapy and surgery for malignant solid tumors. None of them received cranial radiotherapy. Growth hormone reserve was assessed by at least two stimulation tests (clonidine, L-dopa, growth hormone-releasing hormone). In 12 children the reserve of GH pretreatment was also evaluated. Results: Growth hormone deficiency (GHD) was observed in 27 of 60 patients (45%). At diagnosis, mean standing height was +0.23 ± 0.11 standard deviation score (SDS) in the GHD group and +0.16 ± 0.10 SDS in the non-GHD group. Alter chemotherapy, mean standing height in the GHD group was -0.28 ± 0.15 SDS and -0.14 ± 0.11 in the non-GHD group (p < 0.05), and the growth rate was +0.13 ± 0.07 SDS in the GHD group and +0.22 ± 0.18 SDS in the non-GHD group. For a mean follow-up of 30 months, the mean standing height was -0.46 ± 0.29 SDS in the GHD group and -0.24 ± 0.16 SDS for the non-GHD group (p < 0.05), and the growth rate was -0.27 ± 0.19 SDS in the GHD group and -0.16 ± 0.12 SDS in the non-GHD group (p < 0.05). The GH response to clonidine was significantly less than that found with the other stimuli. There was correlation between the dose intensity of some drugs and the subsequent GH response to stimulation tests. The GHD group was found to have received significantly higher doses of actinomycin D than the non-GHD group (p < 0.05). Growth impairment and GHD were not found to be correlated with duration of treatment and follow-up, tumor type, sex, or age. Conclusions: Chemotherapy as the sole form of treatment in children with cancer interferes with growth. The observed impairment of growth depends, at least in part, on a GHD related to chemotherapy. The growth rate in conjunction with the GH response to clonidine provides a sensitive measure of GHD associated with chemotherapy.

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Section: Chemotherapy and Seeretion Of Growth Hormonesupporting

confidence: 83%

Section: Chemotherapy and Seeretion Of Growth Hormonementioning

confidence: 61%

Growth and growth hormone secretion in children with cancer treated with chemotherapy

Román¹,

Villaizán²,

García‐Foncillas³

et al. 1997

The Journal of Pediatrics

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“…Bu çalışmada, temel olarak ele alınan mesleki açıdan yapılan boy uzunluğu öl-çümlerinin yanı sıra, adli tıp uzmanları; tazminat davalarına esas olmak üzere maluliyet raporu dü-zenlerken yaptıkları muayeneler ve postmortem rutin incelemeler sırasında, endokrinolojik travmaların etkileri incelenirken, yaş tayini olgularında ve kimliklendirmede boy ölçümleri yapmaktadır-lar. 5,7,8,[12][13][14][15] Türk Silahlı Kuvvetleri Sağlık Yeteneği Yönetmeliği ve Emniyet Teşkilatı Sağlık Şartları Yönetmeliği uyarınca, bu teşkilatlarda çalışmak üzere başvuran kişilerde boy uzunluğu ölçümleri rutin olarak yapılmakta ve bazen ölçümler arasın-daki farklılıklar nedeni ile boy uzunluğu dava konusu olabilmektedir. 16,17 Boy ölçümünün yanı sıra, bazen ekstremite uzunlukları da önemli bir konu olarak karşımıza çıkabilmektedir.…”

Section: Boy Uzunluğunun Adli̇ Tip Açisindan öNemi̇unclassified

Errors in Occupational Height Measurements and Suggestions to Reduce Errors

Yıldırım¹,

Odabaşı²,

Akçan³

2017

Turkiye Klinikleri J Foren Med

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“…F r e q ü ê n c i a: quanto maior a dose de irradiação, maior a chance de deficiência de GH, a qual ocorreu em 56% dos pacientes que receberam 24 Gy e em 100% daqueles cujo tratamento comportou doses superiores a 45 Gy (6). Prazo de surgimento: quanto maior a dose recebida, mais rapidamente se manifesta a disfunção somatotrópica.…”

Section: Deficiência De Ghunclassified

Seqüelas endócrinas da radioterapia no tratamento do câncer na infância e adolescência

Couto-Silva

Brauner

Adan

2005

Arq Bras Endocrinol Metab

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RESUMOA radioterapia resulta em endocrinopatias, osteoporose, obesidade e seqüelas neurológicas em pacientes tratados por câncer. A deficiência de GH é a complicação mais freqüente no eixo hipotálamo-hipofisário. A freqüência, prazo de surgimento e gravidade da deficiência de GH dependem da dose recebida durante a irradiação craniana, mas idade à radioterapia e fracionamento da dose também são variáveis importantes. Outras anormalidades do eixo hipotálamo-hipofisário são igualmente dose-dependentes. Baixas doses de irradiação induzem puberdade precoce ou avançada, enquanto altas doses provocam deficiência gonadotrópica. Complicações endócrinas secundárias à irradiação periférica, como distúrbios gonadais ou tireoidianos são descritos. Mesmo com secreção normal de GH, o crescimento pode ser comprometido por lesões ósseas após irradiação corporal total ou crânio-espinhal. Resultados melhores sobre a estatura final têm sido obtidos com reposição de GH em associação com o tratamento da puberdade precoce ou avançada. O objetivo desta revisão é a abordagem das seqüelas endócrinas tardias da radioterapia. ABSTRACT Endocrine Sequelae After Radiotherapy in Childhood andAdolescence. Radiotherapy may result in endocrine abnormalities, osteoporosis, obesity and neurological sequelae in patients treated for cancer. In the hypothalamo-pituitary area, GH deficiency is the most frequent complication. The frequency, delay of appearance and severity of GH deficiency depend most on the dose delivered during cranial irradiation but variables as age at treatment and fractionation schedule may play an important role as well. Other hypothalamo-pituitary dysfunctions are also dose-dependent. Low dose cranial irradiation may induce precocious or early puberty, while high doses are related to gonadotropin deficiency. Endocrine complications due to extracranial irradiaton such as gonadal or thyroid abnormalities are described. In spite of normal GH secretion, linear growth may be impaired by bone lesions secondary to craniospinal or total body irradiation. Results on final height have been optimized by better indicators of GH therapy associated with adequate treatment of early or precocious puberty. The purpose of this review is to explore the late endocrine sequelae of radiotherapy.

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Growth and Endocrine Disorders Secondary to Cranial Irradiation

Cited by 181 publications

References 51 publications

Growth and growth hormone secretion in children with cancer treated with chemotherapy

Growth and growth hormone secretion in children with cancer treated with chemotherapy

Errors in Occupational Height Measurements and Suggestions to Reduce Errors

Seqüelas endócrinas da radioterapia no tratamento do câncer na infância e adolescência

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