Journal article
Preirradiation endocrinopathies in pediatric brain tumor patients determined by dynamic tests of endocrine function
International journal of radiation oncology, biology, physics, v 54(1), pp 45-50
01 Sep 2002
PMID: 12182973
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To prospectively evaluate pediatric patients with localized primary brain tumors for evidence of endocrinopathy before radiotherapy (RT).
Seventy-five pediatric patients were evaluated with the arginine tolerance test and L-dopa test for growth hormone secretory capacity and activity; thyroid-stimulating hormone surge and thyrotropin-releasing hormone stimulation test for the hypothalamic-thyroid axis; the 1-microg adrenocorticotropin hormone (ACTH) and metyrapone test for ACTH reserve; and, depending on age, a gonadotropin-releasing hormone stimulation test to determine gonadotropin response. The study included 38 male and 37 female patients, age 1-21 years with ependymoma (n = 35), World Health Organization (WHO) Grade I-II astrocytoma (n = 18), WHO Grade III-IV astrocytoma (n = 10), craniopharyngioma (n = 7), optic pathway tumor (n = 4), and germinoma (n = 1). Seven patients receiving dexamethasone at the time of the evaluation were excluded from the final analysis.
Of 68 assessable patient, 45 (66%) had evidence of endocrinopathy before RT, including 15 of 32 patients (47%) with posterior fossa tumors. Of the 45 patients, 38% had growth hormone deficiency, 43% had thyroid-stimulating hormone secretion abnormality, 22% had an abnormality in ACTH reserve, and 13% had an abnormality in age-dependent gonadotropin secretion.
The incidence of pre-RT endocrinopathy in pediatric brain tumor patients is high, including patients with tumors not adjacent to the hypothalamic-pituitary unit. These data suggest an overestimation in the incidence of radiation-induced endocrinopathy. Baseline endocrine function should be determined for brain tumor patients before therapy. The potential for radiation-induced endocrinopathy alone cannot be used as an argument for alternatives to RT for most patients. Pre-RT endocrinopathy may be an early indicator of central nervous system damage that will influence the functional outcome unrelated to RT.
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Details
- Title
- Preirradiation endocrinopathies in pediatric brain tumor patients determined by dynamic tests of endocrine function
- Creators
- Thomas E Merchant - St. Jude Children's Research HospitalTani Williams - St. Jude Children's Research HospitalJulie M Smith - St. Jude Children's Research HospitalSusan R Rose - St. Jude Children's Research HospitalRobert K Danish - St. Jude Children's Research HospitalGeorge A Burghen - St. Jude Children's Research HospitalLarry E Kun - St. Jude Children's Research HospitalRobert H Lustig - St. Jude Children's Research Hospital
- Publication Details
- International journal of radiation oncology, biology, physics, v 54(1), pp 45-50
- Publisher
- Elsevier
- Grant note
- P30 CA 21765 / NCI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000177780900006
- Scopus ID
- 2-s2.0-0036719859
- Other Identifier
- 991021448060304721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging