Endocrinological outcome in children and adolescents survivors of central nervous system tumours after a 5 year follow-up

• Published in: Anales de Pediatría Vol. 80; no. 6; pp. 357 - 364
• Main Authors: Güemes Hidalgo, M, Muñoz Calvo, M T, Fuente Blanco, L, Villalba Castaño, C, Martos Moreno, G A, Argente, J
• Format: Journal Article
• Language: Spanish; English
• Published: Spain 01.06.2014
• Subjects: Adolescent; Central Nervous System Neoplasms - complications; Child; Child, Preschool; Endocrine System Diseases - etiology; Female; Follow-Up Studies; Humans; Male; Retrospective Studies; Survivors; Time Factors; Cancer survivors; Hypothalamic pituitary axis; Supervivientes de cáncer; Tumores cerebrales infantiles; Endocrine late effects; Secuelas endocrinas; Eje hipotálamo-hipofisario; Childhood brain tumours
• ISSN: 2341-2879; 1695-9531; 2341-2879
• DOI: 10.1016/j.anpede.2013.06.002

Given the successful increase in survival rates with the current treatments for central nervous system tumours (CNST), survivors are at high risk for late adverse effects. To evaluate the endocrine sequelae in children with CNST according to the type of tumour and treatment received. A retrospective review of the clinical features, auxology, hormone determinations and imaging findings of 38 patients (36.8% females, 63.2% males) with CNST, with a minimum of 5 years follow-up, was performed. The mean age at diagnosis was 5.34 ± 3.07 years, with 76.3% of the patients having at least one hormone deficiency, of which growth hormone (GH) (73.7% of all patients) was the most prevalent, followed by thyrotropin (TSH) (68.4%), corticotropin (31.6%), antidiuretic hormone (28.9%), and gonadotropin (LH/FSH) (21.1%) deficiency. Precocious puberty was found in 21.1% of patients. After 5 years of follow-up, 28.9% were obese. Craniopharyngioma had more hormone deficiencies, obesity and recurrence rates. The most frequently administered treatment was surgery + chemotherapy + radiotherapy, in 47.4% of the patients. Mean final height (20 patients) was -1.2 1.6 SDS, with a mean difference of -0.53 SDS regarding their target height. 1) The type of tumour and treatment received influence the endocrinological sequelae. 2) The most frequent hormone deficiencies in all types of CNST, regardless of the treatment received, were GH and TSH. 3) Early diagnosis and prompt intervention of endocrine dysfunction can reduce the morbidity and improve quality of life over the long term.