Bone mineral density and nutrition in long-term survivors of childhood brain tumors

Kvammen, Janne Anita; Stensvold, Einar; Godang, Kristin; Bollerslev, Jens; Myklebust, Tor Åge; Brandal, Petter; Henriksen, Christine; Bechensteen, Anne Grete

doi:10.1016/j.clnesp.2022.05.025

Cited by 2 publications

(1 citation statement)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to hypogonadism and irradiation, two recent cohort studies showed that decreased bone mineral density in pediatric brain tumor survivors is associated with inadequate calcium and vitamin D intake, vitamin D deficiency, and an inactive lifestyle [ 99 , 100 ].…”

Section: Late Endocrine Consequences and Their Managementmentioning

confidence: 99%

Endocrine Disorders in Children with Brain Tumors: At Diagnosis, after Surgery, Radiotherapy and Chemotherapy

2022

View full text Add to dashboard Cite

Introduction: Brain tumors are the second most frequent type of all pediatric malignancies. Depending on their localization, patients with brain tumors may present neurological or ophthalmological symptoms, but also weight anomalies and endocrine disorders ranging from growth hormone deficiency, anomalies of puberty, diabetes insipidus to panhypopituitarism. Immediately at diagnosis, all patients with brain tumors require a complete assessment of the hypothalamic–pituitary function in order to address eventual endocrine disorders. Moreover, children and adolescents undergoing brain surgery must receive peri- and postoperative hydrocortisone stress therapy. Post-operative disorders of water homeostasis are frequent, ranging from transient diabetes insipidus, as well as syndrome of inappropriate antidiuretic hormone secretion to persistent diabetes insipidus. Late endocrine disorders may result from surgery near or within the hypothalamic–pituitary region. Pituitary deficits are frequent after radiotherapy, especially growth hormone deficiency. Thyroid nodules or secondary thyroid cancers may arise years after radiotherapy. Gonadal dysfunction is frequent after chemotherapy especially with alkylating agents. Conclusion: Early detection and treatment of specific endocrine disorders at diagnosis, perioperatively, and during long-term follow-up result in improved general and metabolic health and quality of life.

show abstract

Section: Late Endocrine Consequences and Their Managementmentioning

confidence: 99%

Endocrine Disorders in Children with Brain Tumors: At Diagnosis, after Surgery, Radiotherapy and Chemotherapy

2022

View full text Add to dashboard Cite

show abstract

Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis

Velentza,

Filis,

Wilhelmsson

et al. 2024

Pediatrics

View full text Add to dashboard Cite

CONTEXT: There is an increasing population of childhood cancer survivors (CCS) at risk for treatment-related toxicities, including skeletal morbidities. Bone mineral density (BMD) is a proxy for bone health and reductions are associated with osteoporosis and fractures. OBJECTIVE: To investigate bone health in CCS by conducting a systematic review and meta-analysis of BMD after completed treatments. DATA SOURCES: We searched Medline, Embase, Cochrane, and Web of Science in May 2019 and updated in May 2023. STUDY SELECTION: Studies reporting BMD Z-scores measured with dual-energy x-ray absorptiometry in CCS after treatment completion. DATA EXTRACTION: We performed a pooled analysis of studies reporting BMD Z-scores and thereafter we analyzed studies comparing BMD in survivors and healthy controls. All analyses were performed based on the site of BMD measurement. RESULTS: Of 4243 studies, 84 were included (N = 8106). The mean time off-treatment across the studies ranged from 2 months to 24 years. The overall pooled mean Z-score was −0.57 (95% confidence interval [CI] −0.59 to −0.55) in the whole-body, −0.84 (95% CI −0.86 to −0.83) in the lumbar spine, −0.79 (95% CI −0.81 to −0.77) in the femoral neck and −0.14 (95% CI −0.18 to −0.11) in the total hip. When comparing survivors with controls, BMD was significantly lower in survivors at all sites. LIMITATIONS: English publications, study-level meta-analysis. CONCLUSIONS: We showed a significant reduction of BMD Z-scores in CCS. Given the increased fracture risk already within −1 SD, these results emphasize the need for BMD surveillance and secondary prevention in CCS.

show abstract

Bone mineral density and nutrition in long-term survivors of childhood brain tumors

Cited by 2 publications

References 44 publications

Endocrine Disorders in Children with Brain Tumors: At Diagnosis, after Surgery, Radiotherapy and Chemotherapy

Endocrine Disorders in Children with Brain Tumors: At Diagnosis, after Surgery, Radiotherapy and Chemotherapy

Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis

Contact Info

Product

Resources

About