Growth impairment and gonadal axis abnormalities are common in survivors of paediatric brain tumours

• DOI: 10.1111/apa.13975
• Publication Date: 2017-07-06T17:16:34Z
• Authors: Sari Pietilä; Anne Mäkipernaa; Anna‐Maija Koivisto; Hanna L. Lenko
• Keywords: Adult; Male; Adolescent; Brain Neoplasms; Hormone Replacement Therapy; Hypogonadism; Infant; Adolescent Development; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Cancer Survivors; Child, Preschool; Growth Hormone; Humans; Female; Child

AbstractAimChildhood brain tumour survivors have a high risk of endocrine morbidity. This study evaluated the growth, pubertal development and gonadal function in survivors of childhood brain tumours and identified factors associated with the problems we observed.MethodsThe 52 subjects (52% male) were diagnosed in 1983–1997 and treated for brain tumours at Tampere University Hospital, Finland. They were followed up at a mean age of 14.2 (3.8–28.7) years, a mean of 7.5 (1.5–15.1) years after diagnosis.ResultsWe found that 30 (58%) participants had a lower height standard deviation score at follow‐up than at diagnosis and short stature at follow‐up was associated with tumour malignancy (p = 0.005), radiotherapy (p = 0.004), chemotherapy (p = 0.024), growth hormone deficiency (p < 0.001), hypogonadism (p = 0.044) and delayed puberty (p = 0.021). We found that five needed sex hormones to induce puberty, one had precocious puberty, 12 (23%) had growth hormone deficiency and eight (22%) of the 36 pubertal or postpubertal patients had hypogonadism. Testicular volume was low in 83% of late or postpubertal male survivors.ConclusionGrowth impairment, growth hormone deficiency and hypogonadism were common in childhood brain tumour survivors and low testicular volume was also common in male survivors. Lifelong annual follow‐up checks are indicated for survivors.