Long-term effects of cranial irradiation on endocrine function in children with brain tumors a prospective study
✍ Scribed by Patricia K. Duffner; Michael E. Cohen; Mary L. Voorhess; Margaret H. Macgillivray; Martin L. Brecher; Alvin Panahon; Behzad B. Gilani
- Publisher
- John Wiley and Sons
- Year
- 1985
- Tongue
- English
- Weight
- 451 KB
- Volume
- 56
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
This study prospectively evaluated the endocrine function of 11 children treated with cranial irradintion (CRT) for brain tumors. All tumors were remote from the hypothalamic-pituitary axis. Children were studied before treatment and at 3,6, and 12 months after the completion of CRT. T4, thyroid-stimulating hormone, prolactin, plasma cortisol, and urinary follicle-stimulating hormone and lueteinizing hormone values were normal before and after treatment in all patients. Growth hormone (GH) deficiency was identified in 0 of 7 patients before treatment, in 2 of 7 patients 3 months postCRT, in 9 of 11 patients 6 months post-CRT, and in 7 of 8 patients 12 months post-CRT. Growth deceleration was identified in five of seven prepubertal patients. GH deficiency is an extremely common sequelae of CRT, beginning as early as 3 months after the completion of CRT. The deficit is progressive over time.
Comer 56:2189-2193, 1985.
ETROSPECTIVE STUDIES have documented significant R endocrinopathies in children treated with cranial irradiation (CRT) for brain tumors. In view of these results, a prospective study of children with brain tumors was undertaken to determine the time of onset and the possible progressive nature of these hormonal deficiencies.
Materials and Methods
Eleven children with brain tumors remote from the hypothalamic-pituitary axis were evaluated. Three children had supratentorial tumors: one medulloepithelioma, one mixed glioma, and one Grade II/III astrocytoma. Eight children had posterior fossa tumors: one brain stem glioma, three fourth ventricular ependymomas, two cerebellar astrocytomas, and two medulloblastomas. Treatment consisted of surgery in 1 1 of 11 patients. Wholebrain radiation alone or local radiation to the tumor bed was given to three patients. Four patients received radiation to the craniospinal axis (i.e., whole brain, posterior fossa, and spinal cord) and four received radiation to the posterior fossa alone. Chemotherapy (methotrexate,