ESPE2024 Poster Category 1 Pituitary, Neuroendocrinology and Puberty 4 (9 abstracts)
Endocrine Deficiency after Photon and Proton Radiotherapy for Medulloblastoma in Hokkaido University Hospital, Japan.
Naoya Kaneko , Nozomi Hishimura , Syuntaro Morikawa , Yukayo Terashita , Shinsuke Hirabayashi , Yuko Cho , Takayuki Hashimoto , Shigeru Yamaguchi & Atsushi Manabe
Hokkaido University Hospital, Sapporo, Japan
Background: Medulloblastoma accounts for about 10% of pediatric brain tumor, and about 60 to 100 cases occur in Japan per year. After tumor removal, chemotherapy and radiation therapy including craniospinal irradiation (CSI) are performed. Since the irradiation range of CSI includes hypothalamus, pituitary gland, thyroid, ovaries, and spine, it is known that endocrine deficiency and growth disorders are frequent as late effects. In this study, we aim to highlight the clinical course of endocrine complications in patients with pediatric medulloblastoma treated in Hokkaido University Hospital.
Methods: 17 pediatric medulloblastoma patients who were treated with chemotherapy and photon (n = 8) or proton (n = 9) radiation therapy in Hokkaido University hospital between 1990 and 2022 and currently visiting as outpatients were examined retrospectively using medical records.
Result: The median age of diagnosis was 5.0 and 10.7 years for photon and proton groups. The median follow-up time after completion of treatment was 14.8 and 3.6 years. Gender and CSI dose were similar in both groups. The number of patients of hypothyroidism was 6 (75%) for photon group, and the median time between the completion of treatment and the start of replacement therapy was 4.6 years. There were no patients of hypothyroidism in proton group. The number of patients of growth hormone deficiency who were treated GH was 5 (63%) and 3 (33%), and of hypogonadism was 2(25%) and 2(22%), and of adrenal insufficiency was 1(13%) and 0 (0%) and of precocious puberty was 1(13%) and 0(0%). Thyroid nodules were detected in three patients of photon group by ultrasound, and one patient was diagnosed papillary adenocarcinoma.
Conclusions: Proton therapy may reduce hypothyroidism and thyroid neoplasm of patients who treated for medulloblastoma.
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