ESPE Abstracts

Background: Survival from brain tumors is increasing in children and these patients will likely have severely GH deficiency.

Objective and hypotheses: To evaluate the effect of GH treatment (GHT) in children treated for brain tumor successfully.

Method: Thirteen patients who received GHT after brain tumor treatment were evaluated retrospectively. Height SDS, annual growth rate SDS, height gain, and serum IGF1 levels were collected at baseline and at the time of evaluation.

Results: Mean age of patients was 15.4±4 (five females and eight males). Eight (61.5%) of the patients had medulloblastoma, 4 (30%) craniofarengeoma, and 1 (7.7%) pinealoma. Patients with medulloblastoma and pinealoma underwent chemotherapy and craniospinal radiotherapy post-operatively. One case with craniofarengeoma underwent cranial radiotherapy because of recurrence. At the time of diagnosis, 77% were pre-pubertal, 27% were pubertal and height SDS was −1.5±1.7. Mean time to initiation of GHT and duration of GHT was 38.6±15.5 and 33.5±17 months respectively. Height SDS, growth velocity SDS and IGF1 SDS was −2.3±1.6, −3.2±2.4, and 1.8±0.6 at baseline respectively. During GHT height SDS for the first, second and third year was −1.1±1.2, −0.6±1.3, and −0.9±1.2. IGF SDS was between −0.2 and +0.4 SDS during treatment. Delta height SDS was +1.1 SD. Four patients reached final height during the time of evaluation and are receiving GHT in adult dose. Their final height were −1.2±1.5 SDS. GHT was discontinued in 6 patients (recurrence: 2, final height access: 2, poor treatment adherence: 1, and non-responsive: 1). Recurrence was observed in two patients with pinealoma and medulloblastoma.

Conclusion: Children with brain tumor after remission should be monitored for GH and other pituitary hormone deficiencies to increase final height.