High Prevalence of Early Endocrine Disorders After Childhood Brain Tumors in a Large Cohort.

Abstract

CONTEXT:

Endocrine complications are common in pediatric brain tumor patients.

OBJECTIVE:

We aimed to describe the endocrine follow-up of patients with primary brain tumors.

METHODS:

This is a noninterventional observational study based on data collection from medical records of 221 patients followed at a Pediatric Endocrinology Department.

RESULTS:

Median age at diagnosis was 6.7 years (range, 0-15.9), median follow-up 6.7 years (0.3-26.6), 48.9% female. Main tumor types were medulloblastoma (37.6%), craniopharyngioma (29.0%), and glioma (20.4%). By anatomic location, 48% were suprasellar (SS) and 52% non-suprasellar (NSS). Growth hormone deficiency (GHD) prevalence was similar in both groups (SS: 83.0%, NSS: 76.5%; P = 0.338), appearing at median 1.8 years (-0.8 to 12.4) after diagnosis; postradiotherapy GHD appeared median 1.6 years after radiotherapy (0.2-10.7). Hypothyroidism was more prevalent in SS (76.4%), than NSS (33.9%) (P < 0.001), as well as ACTH deficiency (SS: 69.8%, NSS: 6.1%; P < 0.001). Early puberty was similar in SS (16%) and NSS (12.2%). Hypogonadotropic hypogonadism was predominant in SS (63.1%) vs NSS (1.3%), P < 0.001, and postchemotherapy gonadal toxicity in NSS (29.6%) vs SS (2.8%), P < 0.001. Adult height was lower for NSS compared to target height (-1.0 SD, P < 0.0001) and to SS patients (P < 0.0001). Thyroid nodules were found in 13/45 patients (28.8%), including 4 cancers (4.8-11.5 years after radiotherapy). Last follow-up visit BMI was higher in both groups (P = 0.0001), and obesity incidence was higher for SS (46.2%) than NSS (17.4%).

CONCLUSION:

We found a high incidence of early-onset endocrine disorders. An endocrine consultation and nutritional evaluation should be mandatory for all patients with a brain tumor, especially when the tumor is suprasellar or after hypothalamus/pituitary irradiation.

• Authors: Laura Gabriela González Briceño, Dulanjalee Kariyawasam, Dinane Samara-Boustani, Elisa Giani, Jacques Beltrand, Stéphanie Bolle, Brice Fresneau, Stéphanie Puget, Christian Sainte-Rose, Claire Alapetite, Graziella Pinto, Marie-Liesse Piketty, Séverine Brabant, Samuel Abbou, Isabelle Aerts, Kevin Beccaria, Marie Bourgeois, Thomas Roujeau, Thomas Blauwblomme, Federico Di Rocco, Caroline Thalassinos, Christian Pauwels, Charlotte Rigaud, Syril James, Kanetee Busiah, Albane Simon, Franck Bourdeaut, Lauriane Lemelle, Léa Guerrini-Rousseau, Daniel Orbach, Philippe Touraine, François Doz, Christelle Dufour, Jacques Grill, Michel Polak
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 107 Issue 5 Pg. e2156-e2166 (04 19 2022) ISSN: 1945-7197 [Electronic] United States
• PMID: 34918112 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Adult
• Brain Neoplasms (epidemiology, radiotherapy)
• Cerebellar Neoplasms (complications, radiotherapy)
• Child
• Endocrine System Diseases (diagnosis, epidemiology, etiology)
• Female
• Humans
• Male
• Pituitary Neoplasms (complications, epidemiology)
• Prevalence
• Retrospective Studies