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High Prevalence of Early Endocrine Disorders After Childhood Brain Tumors in a Large Cohort.

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Titel: High Prevalence of Early Endocrine Disorders After Childhood Brain Tumors in a Large Cohort.
Autoren: González Briceño, L.G., Kariyawasam, D., Samara-Boustani, D., Giani, E., Beltrand, J., Bolle, S., Fresneau, B., Puget, S., Sainte-Rose, C., Alapetite, C., Pinto, G., Piketty, M.L., Brabant, S., Abbou, S., Aerts, I., Beccaria, K., Bourgeois, M., Roujeau, T., Blauwblomme, T., Di Rocco, F., Thalassinos, C., Pauwels, C., Rigaud, C., James, S., Busiah, K., Simon, A., Bourdeaut, F., Lemelle, L., Guerrini-Rousseau, L., Orbach, D., Touraine, P., Doz, F., Dufour, C., Grill, J., Polak, M.
Publikationsjahr: 2022
Bestand: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Schlagwörter: Adult, Brain Neoplasms/epidemiology, Brain Neoplasms/radiotherapy, Cerebellar Neoplasms/complications, Cerebellar Neoplasms/radiotherapy, Child, Endocrine System Diseases/diagnosis, Endocrine System Diseases/epidemiology, Endocrine System Diseases/etiology, Female, Humans, Male, Pituitary Neoplasms/complications, Pituitary Neoplasms/epidemiology, Prevalence, Retrospective Studies, Brain tumor, childhood cancer, endocrine disorders, non-suprasellar, suprasellar
Beschreibung: Endocrine complications are common in pediatric brain tumor patients. We aimed to describe the endocrine follow-up of patients with primary brain tumors. This is a noninterventional observational study based on data collection from medical records of 221 patients followed at a Pediatric Endocrinology Department. Median age at diagnosis was 6.7 years (range, 0-15.9), median follow-up 6.7 years (0.3-26.6), 48.9% female. Main tumor types were medulloblastoma (37.6%), craniopharyngioma (29.0%), and glioma (20.4%). By anatomic location, 48% were suprasellar (SS) and 52% non-suprasellar (NSS). Growth hormone deficiency (GHD) prevalence was similar in both groups (SS: 83.0%, NSS: 76.5%; P = 0.338), appearing at median 1.8 years (-0.8 to 12.4) after diagnosis; postradiotherapy GHD appeared median 1.6 years after radiotherapy (0.2-10.7). Hypothyroidism was more prevalent in SS (76.4%), than NSS (33.9%) (P < 0.001), as well as ACTH deficiency (SS: 69.8%, NSS: 6.1%; P < 0.001). Early puberty was similar in SS (16%) and NSS (12.2%). Hypogonadotropic hypogonadism was predominant in SS (63.1%) vs NSS (1.3%), P < 0.001, and postchemotherapy gonadal toxicity in NSS (29.6%) vs SS (2.8%), P < 0.001. Adult height was lower for NSS compared to target height (-1.0 SD, P < 0.0001) and to SS patients (P < 0.0001). Thyroid nodules were found in 13/45 patients (28.8%), including 4 cancers (4.8-11.5 years after radiotherapy). Last follow-up visit BMI was higher in both groups (P = 0.0001), and obesity incidence was higher for SS (46.2%) than NSS (17.4%). We found a high incidence of early-onset endocrine disorders. An endocrine consultation and nutritional evaluation should be mandatory for all patients with a brain tumor, especially when the tumor is suprasellar or after hypothalamus/pituitary irradiation.
Publikationsart: article in journal/newspaper
Sprache: English
ISSN: 1945-7197
Relation: The Journal of Clinical Endocrinology & Metabolism; https://iris.unil.ch/handle/iris/123260; serval:BIB_52C9C838F101; 000756771900001
DOI: 10.1210/clinem/dgab893
Verfügbarkeit: https://iris.unil.ch/handle/iris/123260
https://doi.org/10.1210/clinem/dgab893
Dokumentencode: edsbas.3E8D6936
Datenbank: BASE
Beschreibung
Abstract:Endocrine complications are common in pediatric brain tumor patients. We aimed to describe the endocrine follow-up of patients with primary brain tumors. This is a noninterventional observational study based on data collection from medical records of 221 patients followed at a Pediatric Endocrinology Department. Median age at diagnosis was 6.7 years (range, 0-15.9), median follow-up 6.7 years (0.3-26.6), 48.9% female. Main tumor types were medulloblastoma (37.6%), craniopharyngioma (29.0%), and glioma (20.4%). By anatomic location, 48% were suprasellar (SS) and 52% non-suprasellar (NSS). Growth hormone deficiency (GHD) prevalence was similar in both groups (SS: 83.0%, NSS: 76.5%; P = 0.338), appearing at median 1.8 years (-0.8 to 12.4) after diagnosis; postradiotherapy GHD appeared median 1.6 years after radiotherapy (0.2-10.7). Hypothyroidism was more prevalent in SS (76.4%), than NSS (33.9%) (P < 0.001), as well as ACTH deficiency (SS: 69.8%, NSS: 6.1%; P < 0.001). Early puberty was similar in SS (16%) and NSS (12.2%). Hypogonadotropic hypogonadism was predominant in SS (63.1%) vs NSS (1.3%), P < 0.001, and postchemotherapy gonadal toxicity in NSS (29.6%) vs SS (2.8%), P < 0.001. Adult height was lower for NSS compared to target height (-1.0 SD, P < 0.0001) and to SS patients (P < 0.0001). Thyroid nodules were found in 13/45 patients (28.8%), including 4 cancers (4.8-11.5 years after radiotherapy). Last follow-up visit BMI was higher in both groups (P = 0.0001), and obesity incidence was higher for SS (46.2%) than NSS (17.4%). We found a high incidence of early-onset endocrine disorders. An endocrine consultation and nutritional evaluation should be mandatory for all patients with a brain tumor, especially when the tumor is suprasellar or after hypothalamus/pituitary irradiation.
ISSN:19457197
DOI:10.1210/clinem/dgab893