Abstract
INTRODUCTION: Survival following treatment of paediatric medulloblastomas has significantly improved over the past few decades, but as a consequence, late effects, particularly endocrine sequelae, have been recognized. The complete picture of late effects, however, has been limited by short duration of follow-up.
AIM: To establish the evolution of endocrine sequelae in patients treated for medulloblastoma.
METHODS: Single-centre analysis of medulloblastoma treatment and endocrine sequelae in patients diagnosed between 1982 and 2002.
RESULTS: A total of 109 patients were treated for medulloblastoma, with various treatment modalities involving radio- and chemotherapy. Only 45 (41%) patients remained alive, and details of treatment and late effects were available for 35 (25 m). The median age at diagnosis was 8 (range 2-14) years, and the median follow-up was 18 (range 10-28) years. Growth hormone deficiency (GHD) was the most prevalent hormone deficiency (97%), followed by primary hypothyroidism (60%) and adrenocorticotrophic hormone (ACTH) deficiency (45·5%). The median time from end of treatment to loss of growth hormone was 1·7 (range 0·7-15) years, ACTH deficiency 2·9 (range 0·75-7·5) years and hypothyroidism 4·1 (range 0·7-11·4) years. Twenty-three percentage developed hypogonadism (17% primary and 6% secondary), whilst precocious puberty was seen in 20%. Endocrinopathies appeared to be more prevalent in those treated with concomitant chemotherapy and radiotherapy.
CONCLUSIONS: Prevalence of endocrine sequelae in medulloblastoma survivors is high, and evolution of endocrine dysfunction can occur as late as 15 years from treatment completion; hence, long-term close monitoring of growth, puberty and gonadal function is essential.
Original language | English |
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Pages (from-to) | 663-670 |
Number of pages | 8 |
Journal | Clinical Endocrinology |
Volume | 83 |
Issue number | 5 |
Early online date | 8 May 2015 |
DOIs | |
Publication status | Published - Nov 2015 |
Bibliographical note
© 2015 John Wiley & Sons Ltd.Keywords
- Adolescent
- Antineoplastic Agents/adverse effects
- Cerebellar Neoplasms/drug therapy
- Child
- Child, Preschool
- Combined Modality Therapy/adverse effects
- Endocrine System Diseases/etiology
- Female
- Follow-Up Studies
- Humans
- Male
- Medulloblastoma/drug therapy
- Radiotherapy/adverse effects