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

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González Briceño, Laura Gabriela | Kariyawasam, Dulanjalee | Samara-Boustani, Dinane | Giani, Elisa | Beltrand, Jacques | Bolle, Stéphanie | Fresneau, Brice | Puget, Stéphanie | Sainte-Rose, Christian | Alapetite, Claire | Pinto, Graziella | Piketty, Marie-Liesse | Brabant, Séverine | Abbou, Samuel | Aerts, Isabelle | Beccaria, Kevin | Bourgeois, Marie | Roujeau, Thomas | Blauwblomme, Thomas | Di Rocco, Federico | Thalassinos, Caroline | Pauwels, Christian | Rigaud, Charlotte | James, Syril | Busiah, Kanetee | Simon, Albane | Bourdeaut, Franck | Lemelle, Lauriane | Guerrini-Rousseau, Léa | Orbach, Daniel | Touraine, Philippe | Doz, François | Dufour, Christelle | Grill, Jacques | Polak, Michel

Edité par CCSD ; Endocrine Society -

International audience. 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.

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