Abstract
The present therapeutic modality of combining radiation and chemotherapy to treat PNET patients cause significantly worse growth than radiation alone in PNET survivors. Unlike previous reports focused upon growth response to GH treatment following cranio-spinal irradiation, we evaluated the growth response to GH treatment (Rx) in 16 GH deficient PNET pts treated with radiation and chemotherapy and compared their response to 29 pts with idiopathic GH deficiency (IGHD). The GH treatment was identical, using recombinant GH at a dose of 0.04 mg/kg/dally subcutaneously. The mean duration of time from diagnosis of PNET to GH Rx was 4.2 (+/− 1.6) yrs. Growth response to GH is presented as a velocity standard deviation score (Z) with SD in brackets.
The pre-Rx height (HI)Z score was greater in the PNET pts than IGHD pts, but the pre-treatment growth velocity was significantly worse. The PNET pts demonstrated a significantly poorer response to GH in the first year as compared to IGHD, unlike previous reports. Although PNET pts, as a group, continued to show positive growth velocity Z scores. Ht Z scores (as shown by others) did not increase significantly. Growth response was not correlated to age at diagnosis of PNET, nor to age at GH Rx. nor to duration between diagnosis and initiation of GH Rx. Crown-rump measurements would indicate that impaired spinal growth does not account for the modest response to GH during the first year. A possible explanation is that chemotherapeutic agents can, in certain circumstances, cause relative insensitivity to growth factors.
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Moshang, T., Grucclo, D., Carmargo, A. et al. LONG-TERM GROWTH RESPONSE TO GROWTH HORMONE (GH) TREATMENT IN GH DEFICIENT MEDULLOBLASTOMA (PNET) SURVIVORS. Pediatr Res 33 (Suppl 5), S50 (1993). https://doi.org/10.1203/00006450-199305001-00284
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DOI: https://doi.org/10.1203/00006450-199305001-00284