Abstract
Of a cohort of 132 children alive and well following treatment of brain tumours remote from the hypothalamus or pituitary with radiotherapy, 96% had evidence of GH abnormality. 32 had completed their growth. 14 who had received craniospinal irradiation, had final height SDS -2.03 (range, -3.7 to +0.09), sitting height (SH) SDS -3.22 and subischial leg length (SILL) SDS -0.61. 18 treated with cranial irradiation alone had final height SDS -0.93 (range, -2.8 to +2.07), SH SDS -1.24 and STLL SDS -0.53. Thus the effect of spinal irradiation on final height was considerable.
40 children were treated with GH for periods of 1-4 years. 32 had received craniospinal irradiation and 8 cranial irradiation alone. 17 children who had received craniospinal irradiation were treated with GH when prepubertal. Over the first 12 months of treatment mean height velocity SDS increased +2.52 (range -0.9 to +4.84). Mean height SDS for CA increased +0.27 (range -0.3 to +1.55) and height SDS for DA +0.09 (-0.89 to +0.99). Mean SILI. SDS increased +0.33 (-0.41 to +1.13) but SH SDS was not improved. GH giver, to 23 children in puberty was without significant effect on growth.
We conclude: 1. Spinal irradiation adversely affected spinal growth and this did not respond to GH in the doses used. 2. After craniospinal irradiation, GH could only normalise leg growth and must therefore be instituted before puberty. 3. After cranial irradiation alone GH maintained height SDS. 4. Delay in instituting GH treatment leads to an irrevesible loss of final height prognosis.
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Brook, C., Livesey, E. GROWTH AND GROWTH HORMONE (GH) TREATMENT FOLLOWING RADIOTHERAPY OF BRAIN TUMOURS. Pediatr Res 23, 111 (1988). https://doi.org/10.1203/00006450-198801000-00060
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DOI: https://doi.org/10.1203/00006450-198801000-00060