Clement et al found that 25% of survivors of childhood brain tumors were diagnosed with endocrine disorders over 6.6 years of follow-up, based on a Dutch nationwide study reported in the Journal of Clinical Oncology. Hanneke M. van Santen, MD, PhD, of Wilhelmina Children’s Hospital, University Medical Center Utrecht, is the corresponding author of the Journal of Clinical Oncology article.
The study involved data from 718 survivors diagnosed at age ≤ 18 years with a primary brain tumor between January 2002 and December 2012 at 7 of 8 university hospitals in the Netherlands. Patients had to have who survived at least 2 years after diagnosis with stable residual disease or no evidence of disease after completion of therapy at the time of follow-up. Patients had a median age of 7.7 years at diagnosis.
After a median follow-up of 6.6 years, 178 survivors (24.8%) were diagnosed with an endocrine disorder, with 159 patients (22.1%) presenting with at least 1 disorder within 5 years after diagnosis. The most common disorders were growth hormone deficiency (12.5%), precocious puberty (12.2%), thyroid-stimulating hormone deficiency (9.2%), and thyroidal hypothyroidism (5.8%). An increased risk of hypothalamic-pituitary dysfunction, present in 138 survivors overall, was associated with radiotherapy (odds ratio [OR] = 15.74, 95% confidence interval [CI] = 8.72–28.42), younger age at diagnosis (OR = 1.09, 95% CI = 1.04–1.14), greater follow-up time (OR = 1.10, 95% CI = 1.02–1.18), hydrocephalus at diagnosis (OR = 1.77, 95% CI = 1.09–2.88), and suprasellar (OR = 34.18, 95% CI = 14.74–79.29) and infratentorial (OR = 2.65, 95% CI = 1.48–4.74) tumor site.
The investigators concluded: “The prevalence of early endocrine disorders among [childhood brain tumor survivors] is high. The observation that 22.1% of [these survivors] developed at least one endocrine disorder within the first 5 years after diagnosis stresses the importance of early and regular assessment of endocrine function in [survivors] who are at risk for endocrine damage.”
The study was supported by Pfizer and Stichting Kinderen Kankervrij.