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. 1995 Aug;73(2):141–146. doi: 10.1136/adc.73.2.141

Growth and puberty after growth hormone treatment after irradiation for brain tumours.

A L Ogilvy-Stuart 1, S M Shalet 1
PMCID: PMC1511189  PMID: 7574858

Abstract

The impact of treatment with either cranial or craniospinal irradiation with or without cytotoxic chemotherapy for a brain tumour distant from the hypothalamic-pituitary axis was assessed in 29 children who had reached final height. All had received growth hormone treatment for radiation induced growth hormone deficiency. Final height, segmental growth during puberty, and duration of puberty were studied. Both craniospinal irradiation and the use of chemotherapy resulted in a significant and equal reduction in final height; this effect in those children who received both craniospinal irradiation and chemotherapy was additive. The degree of height loss was related to the age at irradiation, the most profound effect on final height occurring in the youngest at irradiation. The mean duration of puberty from G2-G4/B2-B4 (1.97 years) was not significantly different from the duration of puberty in normal children. Growth hormone increases growth velocity in children with radiation induced growth hormone deficiency but their final height is significantly less than their mid-parental height. The use of spinal irradiation and chemotherapy in the original treatment of brain tumours has a marked effect on growth which is not overcome with the use of growth hormone treatment in current doses. Early puberty of normal duration contributes to poor growth.

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Selected References

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  1. Blatt J., Wenger S., Stitely S., Lee P. A. Lack of mitogenic effects of growth hormone on human leukemic lymphoblasts. Eur J Pediatr. 1987 May;146(3):257–260. doi: 10.1007/BF00716469. [DOI] [PubMed] [Google Scholar]
  2. Bourguignon J. P. Variations in duration of pubertal growth: a mechanism compensating for differences in timing of puberty and minimizing their effects on final height. Belgian Study Group for Paediatric Endocrinology. Acta Paediatr Scand Suppl. 1988;347:16–24. [PubMed] [Google Scholar]
  3. Brown I. H., Lee T. J., Eden O. B., Bullimore J. A., Savage D. C. Growth and endocrine function after treatment for medulloblastoma. Arch Dis Child. 1983 Sep;58(9):722–727. doi: 10.1136/adc.58.9.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Clayton P. E., Shalet S. M., Price D. A. Growth response to growth hormone therapy following cranial irradiation. Eur J Pediatr. 1988 Aug;147(6):593–596. doi: 10.1007/BF00442470. [DOI] [PubMed] [Google Scholar]
  5. Clayton P. E., Shalet S. M., Price D. A. Growth response to growth hormone therapy following craniospinal irradiation. Eur J Pediatr. 1988 Aug;147(6):597–601. doi: 10.1007/BF00442471. [DOI] [PubMed] [Google Scholar]
  6. Clayton P. E., Shalet S. M. The evolution of spinal growth after irradiation. Clin Oncol (R Coll Radiol) 1991 Jul;3(4):220–222. doi: 10.1016/s0936-6555(05)80744-7. [DOI] [PubMed] [Google Scholar]
  7. Darendeliler F., Hindmarsh P. C., Preece M. A., Cox L., Brook C. G. Growth hormone increases rate of pubertal maturation. Acta Endocrinol (Copenh) 1990 Mar;122(3):414–416. doi: 10.1530/acta.0.1220414. [DOI] [PubMed] [Google Scholar]
  8. Darendeliler F., Livesey E. A., Hindmarsh P. C., Brook C. G. Growth and growth hormone secretion in children following treatment of brain tumours with radiotherapy. Acta Paediatr Scand. 1990 Oct;79(10):950–956. doi: 10.1111/j.1651-2227.1990.tb11357.x. [DOI] [PubMed] [Google Scholar]
  9. Herber S. M., Dunsmore I. R., Milner R. D. Final stature in brain tumours other than craniopharyngioma: effect of growth hormone. Horm Res. 1985;22(1-2):63–67. doi: 10.1159/000180073. [DOI] [PubMed] [Google Scholar]
  10. Lannering B., Albertsson-Wikland K. Improved growth response to GH treatment in irradiated children. Acta Paediatr Scand. 1989 Jul;78(4):562–567. doi: 10.1111/j.1651-2227.1989.tb17937.x. [DOI] [PubMed] [Google Scholar]
  11. Marshall W. A., Tanner J. M. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969 Jun;44(235):291–303. doi: 10.1136/adc.44.235.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Marshall W. A., Tanner J. M. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970 Feb;45(239):13–23. doi: 10.1136/adc.45.239.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. O'Driscoll B. R., Hasleton P. S., Taylor P. M., Poulter L. W., Gattameneni H. R., Woodcock A. A. Active lung fibrosis up to 17 years after chemotherapy with carmustine (BCNU) in childhood. N Engl J Med. 1990 Aug 9;323(6):378–382. doi: 10.1056/NEJM199008093230604. [DOI] [PubMed] [Google Scholar]
  14. Ogilvy-Stuart A. L., Clayton P. E., Shalet S. M. Cranial irradiation and early puberty. J Clin Endocrinol Metab. 1994 Jun;78(6):1282–1286. doi: 10.1210/jcem.78.6.8200926. [DOI] [PubMed] [Google Scholar]
  15. Olshan J. S., Gubernick J., Packer R. J., D'Angio G. J., Goldwein J. W., Willi S. M., Moshang T., Jr The effects of adjuvant chemotherapy on growth in children with medulloblastoma. Cancer. 1992 Oct 1;70(7):2013–2017. doi: 10.1002/1097-0142(19921001)70:7<2013::aid-cncr2820700734>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  16. Perry-Keene D. A., Connelly J. F., Young R. A., Wettenhall H. N., Martin F. I. Hypothalamic hypopituitarism following external radiotherapy for tumours distant from the adenohypophysis. Clin Endocrinol (Oxf) 1976 Jul;5(4):373–380. doi: 10.1111/j.1365-2265.1976.tb01965.x. [DOI] [PubMed] [Google Scholar]
  17. Probert J. C., Parker B. R., Kaplan H. S. Growth retardation in children after megavoltage irradiation of the spine. Cancer. 1973 Sep;32(3):634–639. doi: 10.1002/1097-0142(197309)32:3<634::aid-cncr2820320316>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  18. Richards G. E., Wara W. M., Grumbach M. M., Kaplan S. L., Sheline G. E., Conte F. A. Delayed onset of hypopituitarism: sequelae of therapeutic irradiation of central nervous system, eye, and middle ear tumors. J Pediatr. 1976 Oct;89(4):553–559. doi: 10.1016/s0022-3476(76)80385-x. [DOI] [PubMed] [Google Scholar]
  19. Romshe C. A., Zipf W. B., Miser A., Miser J., Sotos J. F., Newton W. A. Evaluation of growth hormone release and human growth hormone treatment in children with cranial irradiation-associated short stature. J Pediatr. 1984 Feb;104(2):177–181. doi: 10.1016/s0022-3476(84)80988-9. [DOI] [PubMed] [Google Scholar]
  20. Shalet S. M., Beardwell C. G., Aarons B. M., Pearson D., Jones P. H. Growth impairment in children treated for brain tumours. Arch Dis Child. 1978 Jun;53(6):491–494. doi: 10.1136/adc.53.6.491. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Shalet S. M., Gibson B., Swindell R., Pearson D. Effect of spinal irradiation on growth. Arch Dis Child. 1987 May;62(5):461–464. doi: 10.1136/adc.62.5.461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Shalet S. M., Whitehead E., Chapman A. J., Beardwell C. G. The effects of growth hormone therapy in children with radiation-induced growth hormone deficiency. Acta Paediatr Scand. 1981 Jan;70(1):81–86. doi: 10.1111/j.1651-2227.1981.tb07177.x. [DOI] [PubMed] [Google Scholar]
  23. Sulmont V., Brauner R., Fontoura M., Rappaport R. Response to growth hormone treatment and final height after cranial or craniospinal irradiation. Acta Paediatr Scand. 1990 May;79(5):542–549. doi: 10.1111/j.1651-2227.1990.tb11509.x. [DOI] [PubMed] [Google Scholar]
  24. Wallace W. H., Shalet S. M. Chemotherapy with actinomycin D influences the growth of the spine following abdominal irradiation. Med Pediatr Oncol. 1992;20(2):177–177. doi: 10.1002/mpo.2950200218. [DOI] [PubMed] [Google Scholar]
  25. Winter R. J., Green O. C. Irradiation-induced growth hormone deficiency: blunted growth response and accelerated skeletal maturation to growth hormone therapy. J Pediatr. 1985 Apr;106(4):609–612. doi: 10.1016/s0022-3476(85)80083-4. [DOI] [PubMed] [Google Scholar]
  26. Zachmann M., Prader A., Kind H. P., Häfliger H., Budliger H. Testicular volume during adolescence. Cross-sectional and longitudinal studies. Helv Paediatr Acta. 1974 Apr;29(1):61–72. [PubMed] [Google Scholar]

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