ESPE2022 Free Communications GH and IGFs (6 abstracts)
Growth hormone and childhood-onset craniopharyngioma: When to initiate growth hormone replacement therapy?
Adrien Nguyen Quoc 1,2 , Kévin Beccaria 3,2 , Laura GonzáLez Briceño 1 , Graziella Pinto 1 , Dinane Samara Boustani 1 , Athanasia Stoupa 1 , Jacques Beltrand 1,2 , Alix Besançon 1 , Caroline Thalassinos 1 , Stéphanie Puget 3,2 , Thomas Blauwblomme 3,2 , Claire Alapetite 4,5 , Stéphanie Bolle 6 , François Doz 7,2 , Jacques Grill 8 , Christelle Dufour 8 , Franck Bourdeaut 7 , Samuel Abbou 8 , Léa Guerrini Rousseau 8 , Amaury Leruste 7 , Séverine Brabant 9 , Magali Viaud 1 , Nathalie Boddaert 10,2 , Michel Polak 1,2 & Dulanjalee Kariyawasam 1,2
1Pediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, Paris, France; 2Université Paris Cité, Paris, France; 3Department of Pediatric Neurosurgery, Necker-Enfants Malades University Hospital, AP-HP Centre, Paris, France; 4Radiation Oncology Department, Institut Curie, Paris, France; 5Proton Center, Orsay, France; 6Department of Radiation Oncology, Villejuif, France; 7SIREDO Center (Care, Innovation, Research in, Children, Adolescent and Young Adults Oncology), Institut Curie, Paris, France; 8Child and Adolescent Cancer Department, Gustave Roussy, Villejuif, France; 9Department of Functional Explorations, Necker Children's University Hospital, Paris, France; 10Department of Pediatric Radiology, Necker-Enfants Malades University Hospital, AP-HP Centre, Paris, France
Objective: Craniopharyngioma is a benign brain tumour with frequent local recurrence after treatment. Growth hormone replacement therapy (GHRT) is prescribed in children with growth hormone deficiency due to childhood-onset craniopharyngioma. The objective was to evaluate whether shorter time delay of GHRT initiation after childhood-onset craniopharyngioma completion therapy increased the risk of recurrence.
Design: Our retrospective, observational study compared a cohort of childhood-onset craniopharyngiomas diagnosed between February 2003 and November 2019 all treated with recombinant human growth hormone (rhGH) in the paediatric Necker-Enfants Malades University hospital in Paris, France.
Results: We studied 71 childhood-onset craniopharyngiomas (median age 7,4 years). Twenty-seven patients were treated with rhGH at least 12 months after craniopharyngioma treatment (38%, “>12 months group”) and forty-four patients before 12 months (62%, “<12 months group”) among which twenty-nine patients were treated between 6 and 12 months (40%, “6-12 months group”). The main outcome was the risk of tumour recurrence in the “>12 months” group and in the “<12 months” or in the “6-12 months” group patients. In the “>12 months group”, the 2- and 5- years recurrence-free survivals were respectively 81,5% (95% CI 61,1-91,9) and 69,4% (95% CI 47,9-83,4), as compared with 72,2% (95 IC 56,3-83,1) and 69,8% (95% CI 53,8-81,2) in the “<12 months” group. The 2- and 5- years recurrence-free survivals were the same in the “6-12 months group” (72,4%, 95% CI 52,4-85,1). By Log-rank test, the recurrence-free survival was not different between the “>12 months group” vs the “<12 months group” (P=0,98) or vs the “6-12 months group” (P=0,91). The median time for recurrence was not statistically different between the “>12 months group” (13 months, IQR 3,9-34,9) vs the “<12 months group” (10,4 months, IQR 6,8-18,0, P=0,51) or vs the “6-12 months group” (10,9 months, IQR 8,7-16,2, P=0,66). In univariate and multivariate analysis, the risk of craniopharyngioma recurrence was not associated with the GHRT time delay after craniopharyngioma treatment (>12 months vs <12 months or vs 6-12 months).
Conclusion: No association was found between GHRT time delay after childhood-onset craniopharyngioma treatment and an increased risk of recurrence, suggesting GH replacement therapy can be initiated 6 months after last treatment for craniopharyngiomas.
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