Abstract
OBJECTIVE--To determine whether using growth hormone to treat radiation induced growth hormone deficiency causes tumour recurrence. DESIGN--Comparison of tumour recurrence rates in children treated with growth hormone for radiation induced deficiency and an untreated population. Computed tomograms from children with brain tumours were reviewed when starting growth hormone and subsequently. SETTING--North West region. PATIENTS--207 children treated for brain tumour, 47 of whom received growth hormone and 161 children with acute lymphoblastic leukaemia 15 of whom received growth hormone. MAIN OUTCOME MEASURES--Tumour recurrence and changes in appearances on computed tomography. RESULTS--Among children with brain tumour, five (11%) who received growth hormone had recurrences compared with 42 (26%) who did not receive growth hormone. Also adjusting for other variables that might affect tumour recurrence the estimated relative risk of recurrence was 0.82 (95% confidence interval 0.28 to 2.37). The only child with acute lymphoblastic leukaemia who relapsed while taking growth hormone had relapsed previously before starting treatment. Two of the five children with brain tumours who relapsed had abnormal appearances on computed tomography when growth hormone was started. 14 other children who remained relapse free and had follow up computed tomography showed no deterioration in radiological appearance during treatment. CONCLUSIONS--In this population growth hormone did not increase the risk of tumour recurrence but continued surveillance is essential. Abnormal results on computed tomography are not a contraindication to treatment with growth hormone.
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Selected References
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- Arslanian S. A., Becker D. J., Lee P. A., Drash A. L., Foley T. P., Jr Growth hormone therapy and tumor recurrence. Findings in children with brain neoplasms and hypopituitarism. Am J Dis Child. 1985 Apr;139(4):347–350. doi: 10.1001/archpedi.1985.02140060029020. [DOI] [PubMed] [Google Scholar]
- Bentley H. P., Hughs E. R., Peterson R. D. Effect of hypophysectomy on a virus-induced T-cell leukemia. Nature. 1974 Dec 20;252(5485):747–748. doi: 10.1038/252747a0. [DOI] [PubMed] [Google Scholar]
- Buchanan C. R., Preece M. A., Milner R. D. Mortality, neoplasia, and Creutzfeldt-Jakob disease in patients treated with human pituitary growth hormone in the United Kingdom. BMJ. 1991 Apr 6;302(6780):824–828. doi: 10.1136/bmj.302.6780.824. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Clayton P. E., Shalet S. M. Dose dependency of time of onset of radiation-induced growth hormone deficiency. J Pediatr. 1991 Feb;118(2):226–228. doi: 10.1016/s0022-3476(05)80487-1. [DOI] [PubMed] [Google Scholar]
- Estrov Z., Meir R., Barak Y., Zaizov R., Zadik Z. Human growth hormone and insulin-like growth factor-1 enhance the proliferation of human leukemic blasts. J Clin Oncol. 1991 Mar;9(3):394–399. doi: 10.1200/JCO.1991.9.3.394. [DOI] [PubMed] [Google Scholar]
- Ezzat S., Melmed S. Clinical review 18: Are patients with acromegaly at increased risk for neoplasia? J Clin Endocrinol Metab. 1991 Feb;72(2):245–249. doi: 10.1210/jcem-72-2-245. [DOI] [PubMed] [Google Scholar]
- Leukaemia in patients treated with growth hormone. Lancet. 1988 May 21;1(8595):1159–1160. [PubMed] [Google Scholar]
- Leukaemia in patients treated with growth hormone. Lancet. 1988 May 21;1(8595):1159–1160. [PubMed] [Google Scholar]
- Leukaemia in patients treated with growth hormone. Lancet. 1988 May 21;1(8595):1159–1160. [PubMed] [Google Scholar]
- MOON H. D., SIMPSON M. E., LI C. H., EVANS H. M. Neoplasms in rats treated with pituitary growth hormone; pulmonary and lymphatic tissues. Cancer Res. 1950 May;10(5):297–308. [PubMed] [Google Scholar]
- Rogers P. C., Komp D., Rogol A., Sabio H. Possible effects of growth hormone on development of acute lymphoblastic leukaemia. Lancet. 1977 Aug 27;2(8035):434–435. doi: 10.1016/s0140-6736(77)90613-4. [DOI] [PubMed] [Google Scholar]