Adult height after growth hormone (GH) treatment for GH deficiency due to cranial irradiation
✍ Scribed by Adan, L.; Sainte-Rose, C.; Souberbielle, J.C.; Zucker, J.M.; Kalifa, C.; Brauner, R.
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 174 KB
- Volume
- 34
- Category
- Article
- ISSN
- 0098-1532
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✦ Synopsis
Background. The indications and factors affecting the growth in response to treatment with growth hormone (GH) of patients with cranial irradiation-induced GH deficiency remain unclear. Procedure. The adult heights of 56 patients treated with GH (0.4-0.6 U/kg/week) as daily sc injections were analysed. They had been given 18 or 24 Grays (Gy) cranial irradiation for leukemia (group 1, 26 cases), 50 ± 1 Gy for various tumors (group 2, 13 cases), 46 ± 1 Gy for retinoblastoma (group 3, 8 cases), or 34 ± 2 Gy with spinal irradiation for medulloblastoma (group 4, 9 cases). Twenty-five of these 56 patients had early puberty and were also treated with gonadotropin-releasing hormone (GnRH) analog. Results. The standing (-1.0 ± 0.2 in group 1, -0.7 ± 0.3 in group 2, -1.1 ± 0.3 in group 3, and -2.0 ± 0.4 SD in group 4) and sitting (-1.8 ± 0.2 in group 1, -0.4 ± 0.4 in group 2, -1.2 ± 0.4 in group 3, and -3.4 ± 0.4 SD in group 4) adult heights were shorter (P < 0.05 for standing and P < 0.001 for sitting heights) for group 4 than for each of the other groups. Of the 47 patients given cranial (and not craniospinal) irradiation, sitting adult height was shorter (P = 0.02) and the difference between standing adult and target heights greater (P = 0.03) in those patients in whom puberty occurred at a normal age than in those treated with GnRH analog. Conclusion. The incomplete catch-up of growth seems to be mainly due to the reduction in sitting height of patients given spinal irradiation and in whom puberty occurred at a normal age. This suggests that GnRH analog treatment should be more widely used to treat children with early and/or rapidly progressing puberty after cranial irradiation.