Assessment of Puberty and Hypothalamic–Pituitary–Gonadal Axis Function After Childhood Brain Tumor Treatment

Assessment of Puberty and Hypothalamic–Pituitary–Gonadal Axis Function After Childhood Brain Tumor Treatment

Abstract Context Endocrine complications are common in pediatric brain tumor patients. Objective To describe hypothalamic–pituitary–gonadal axis (HPGA) function in patients treated in childhood for a primary brain tumor more than 5 years earlier, in order to identify risk factors for HPGA impairment...

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Published in:The journal of clinical endocrinology and metabolism Vol. 108; no. 9; pp. e823 - e831
Main Authors: Rosimont, Manon, Kariyawasam, Dulanjalee, Samara-Boustani, Dinane, Giani, Elisa, Beltrand, Jacques, Bolle, Stephanie, Fresneau, Brice, Puget, Stephanie, Sainte-Rose, Christian, Alapetite, Claire, Pinto, Graziella, Touraine, Philippe, Piketty, Marie-Liesse, Brabant, Séverine, Abbou, Samuel, Aerts, Isabelle, Beccaria, Kevin, Bourgeois, Marie, Roujeau, Thomas, Blauwblomme, Thomas, Rocco, Federico Di, Thalassinos, Caroline, Rigaud, Charlotte, James, Syril, Busiah, Kanetee, Simon, Albane, Bourdeaut, Franck, Lemelle, Lauriane, Guerrini-Rousseau, Léa, Orbach, Daniel, Doz, François, Dufour, Christelle, Grill, Jacques, Polak, Michel, Briceño, Laura González
Format: Journal Article
Language:English
Published: US Oxford University Press 18-08-2023
Endocrine Society
Subjects:
Brain cancer
Brain tumors
Chemotherapy
Children
Diagnosis
Endocrinology
Glioma
Growth hormones
Hormone replacement therapy
Hypogonadism
Hypothalamus
Life Sciences
Medulloblastoma
Neoplasia
Patients
Pediatrics
Pituitary
Puberty
Radiation therapy
Risk factors
Toxicity
brain tumor
endocrine disorders
childhood cancer
Brain tumor
Endocrine disorders
Childhood cancer
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Summary:Abstract Context Endocrine complications are common in pediatric brain tumor patients. Objective To describe hypothalamic–pituitary–gonadal axis (HPGA) function in patients treated in childhood for a primary brain tumor more than 5 years earlier, in order to identify risk factors for HPGA impairment. Methods We retrospectively included 204 patients diagnosed with a primary brain tumor before 18 years of age and monitored at the pediatric endocrinology unit of the Necker Enfants-Malades University Hospital (Paris, France) between January 2010 and December 2015. Patients with pituitary adenoma or untreated glioma were excluded. Results Among patients with suprasellar glioma not treated by radiotherapy, the prevalence of advanced puberty was 65% overall and 70% when the diagnosis occurred before 5 years of age. Medulloblastoma chemotherapy caused gonadal toxicity in 70% of all patients and in 87.5% of those younger than 5 years at diagnosis. In the group with craniopharyngioma, 70% of patients had hypogonadotropic hypogonadism, which was consistently accompanied by growth hormone deficiency. Conclusion Tumor type, location, and treatment were the risk main factors for HPGA impairment. Awareness that onset can be delayed is essential to guide information of parents and patients, patient monitoring, and timely hormone replacement therapy.
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ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgad097