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High prevalence of early hypothalamic‐pituitary damage in childhood brain tumor survivors: Need for standardized follow‐up programs
Author(s) -
Clement Sarah C.,
Meeteren Antoinette Y.N. Schoutenvan,
Kremer Leontien C.M.,
van Trotsenburg A.S. Paul,
Caron Huib N.,
van Santen Hanneke M.
Publication year - 2014
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25176
Subject(s) - medicine , endocrine system , pediatrics , subclinical infection , pituitary tumors , population , growth hormone deficiency , hormone , oncology , growth hormone , environmental health
Childhood brain tumor survivors (CBTS) are at increased risk to develop endocrine disorders. Alerted by two cases who experienced delay in diagnosis of endocrine deficiencies within the first 5 years after brain tumor diagnosis, our aim was to investigate the current screening strategy and the prevalence of endocrine disorders in survivors of a childhood brain tumor outside of the hypothalamic‐pituitary region, within the first 5 years after diagnosis. Procedures Firstly, we performed a retrospective study of 47 CBTS treated in our center, diagnosed between 2008 and 2012. Secondly, the literature was reviewed for the prevalence of endocrine disorders in CBTS within the first 5 years after diagnosis. Results Of 47 CBTS eligible for evaluation, in 34% no endocrine parameters had been documented at all during follow up. In the other 66%, endocrine parameters had been inconsistently checked, with different parameters at different time intervals. In 19% of patients an endocrine disorder was found. At literature review 22 studies were identified. The most common reported endocrine disorder within the first 5 years after diagnosis was growth hormone deficiency (13–100%), followed by primary gonadal dysfunction (0–91%) central hypothyroidism (0–67%) and primary/subclinical hypothyroidism (range 0–64%). Conclusion Endocrine disorders are frequently seen within the first 5 years after diagnosis of a childhood brain tumor outside of the hypothalamic‐pituitary region. Inconsistent endocrine follow up leads to unnecessary delay in diagnosis and treatment. Endocrine care for this specific population should be improved and standardized. Therefore, high‐quality studies and evidence based guidelines are warranted. Pediatr Blood Cancer 2014;61:2285–2289. © 2014 Wiley Periodicals, Inc.