Dosimetry and growth hormone deficiency following cranial irradiation of childhood brain tumors

Schmiegelow, Marianne; Lassen, S.; Weber, Lars; Poulsen, Hans Skovgaard; Hertz, H; Müller, J.

doi:10.1002/(sici)1096-911x(199912)33:6<564::aid-mpo8>3.3.co;2-e

Cited by 8 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Talvensaari et al (13) and Tillman et al (14) both reported a negative correlation between the dose (15-46 Gy) and the nocturnal GH peak and the integrated nocturnal GH secretion. Schmiegelow et al (15) also found that the GH peak after an arginine test in 16 patients given cranial irradiation for disorders not involving the HP area was negatively correlated with the dose delivered to 90% of the volume of the pituitary. Patients who, by the 90% dose volume, were given more than 37.5 Gy to the HP area had an accumulated risk of GH deficiency of 87% 2.5 yr after irradiation.…”

Section: Discussionmentioning

confidence: 96%

GH Deficiency Caused by Cranial Irradiation during Childhood: Factors and Markers in Young Adults

Adan¹,

Trivin²,

Sainte‐Rose³

et al. 2001

The Journal of Clinical Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

Cranial irradiation alters hypothalamic-pituitary function. We reevaluated 90 patients with GH deficiency caused by fractionated cranial irradiation performed at age 4.9 +/- 0.4 (SE) yr when they were 15.7 +/- 0.2 yr old. Group 1 received 18 Grays (Gy) (7 cases) or 24 Gy (21 cases) for acute lymphoblastic leukemia; group 2, 30-40 Gy for medulloblastoma (22 cases); group 3, 45-60 Gy for optic glioma and various tumors (30 cases); and group 4, 40-50 Gy for retinoblastoma (10 cases). The mean GH peaks after an arginine insulin test in group 3 (1.9 +/- 0.4 microg/liter) was lower than in groups 1 (4.8 +/- 0.5 microg/liter, P < 0.001) and 2 (3.4 +/- 0.5 microg/liter, P < 0.03). The mean plasma IGF-I concentrations in group 3 [-3.8 +/- 0.2 z score (zs)] was lower than in groups 1 (-2.4 +/- 0.3 zs, P < 0.001) and 2 (-3.1 +/- 0.2 zs, P < 0.02), as was the mean in group 4 (-3.9 +/- 0.3 zs, P < 0.01 compared with group 1 and P < 0.05 compared with group 2). GH peaks and IGF-I were correlated positively (P = 0.0001) and negatively with dose (P < 0.001 for GH and P = 0.0001 for IGF-I), but not with age at irradiation. Among the 43 patients with GH peaks below 3 microg/liter, 41 (95%) had plasma IGF-I less than -2 zs. The body mass index (BMI), plasma insulin, and leptin were similar in the four groups. They were positively correlated with each other (P < 0.001 for BMI compared with insulin and with leptin, respectively, and P < 0.01 for insulin compared with leptin), but not with age or dose of irradiation, or with markers of GH secretion. In conclusion, in patients with GH deficiency caused by cranial irradiation, the residual GH secretion and plasma IGF-I depend on the dose. Almost all the patients with severe GH deficiency had low plasma IGF-I. BMI, leptin, and insulin seem to be independent of GH status.

show abstract

Section: Discussionmentioning

confidence: 96%

GH Deficiency Caused by Cranial Irradiation during Childhood: Factors and Markers in Young Adults

Adan¹,

Trivin²,

Sainte‐Rose³

et al. 2001

The Journal of Clinical Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

show abstract

“…18 The frequency and severity of neuroendocrine dysfunction has been shown to be significantly higher in sellar and parasellar tumors in view of their proximity to the HPA, as well as owing to the use of radiotherapy, higher radiation dose, higher dose per fraction, and younger age at radiation. 19 Dosimetric studies have previously shown that SCRT techniques have a potential to deliver lesser doses to the HPA and preserve neuroendocrine function. 20 Our study has proven conclusively that patients treated with SCRT had significantly less incidence of new axes impairment compared with patients treated with conventional radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Stereotactic Conformal Radiotherapy vs Conventional Radiotherapy on Benign and Low-Grade Brain Tumors

et al. 2017

View full text Add to dashboard Cite

show abstract

“…1,2 The actual dose delivered is determined from dosevolume histograms: the hypothalamus and pituitary are expected to receive 10-100% of the total dose, depending on their location between the periphery and the center of the radiation field, respectively. 3 Use of the biological effective dose enables quantification of the biological effects of different radiation schedules, and so provides a consistent method with which to compare effects on hypothalamic and pituitary functions. 4 The biological effective dose has been particularly useful to study the course of radiation-induced growth hormone (GH) deficiency.…”

Section: Epidemiology and Pathophysiology Radiobiologymentioning

confidence: 99%

Radiation-induced hypopituitarism after cancer therapy: who, how and when to test

2009

View full text Add to dashboard Cite

Subtle to frank abnormalities in hypothalamic-pituitary axis function are frequently seen in cancer survivors who have received prophylactic or therapeutic cranial irradiation. The growth hormone (GH) axis is the most vulnerable to radiation damage, and isolated GH deficiency can occur after doses as low as 18 Gy. Furthermore, the frequency of GH deficiency can reach 50-100% within 3-5 years of cranial irradiation with doses of 30-50 Gy. TSH and adrenocorticotropic hormone deficiency occur in 3-6% of patients after conventional irradiation (30-50 Gy). Abnormalities in gonadotropin secretion are dose-dependent: gonadotropin deficiency is seen only after doses of 30 Gy or more, whereas lower doses usually lead to precocious puberty. Hyperprolactinemia predominantly occurs in young women after intensive irradiation and is usually subclinical. The frequencies of gonadotropin, adrenocorticotropic hormone and TSH deficiencies substantially increase with intensive irradiation (greater than 60 Gy) and after conventional irradiation for pituitary tumors, with a cumulative incidence of 30-60% after 10 years. The irreversible and progressive nature of radiation-induced anterior-pituitary hormone deficiencies and their adverse effect on body image, growth, sexual function, skeletal health and quality of life makes it essential that cancer survivors are tested regularly to ensure appropriate diagnosis and timely hormone replacement therapy.

show abstract

Dosimetry and growth hormone deficiency following cranial irradiation of childhood brain tumors

Cited by 8 publications

References 0 publications

GH Deficiency Caused by Cranial Irradiation during Childhood: Factors and Markers in Young Adults

GH Deficiency Caused by Cranial Irradiation during Childhood: Factors and Markers in Young Adults

Efficacy of Stereotactic Conformal Radiotherapy vs Conventional Radiotherapy on Benign and Low-Grade Brain Tumors

Radiation-induced hypopituitarism after cancer therapy: who, how and when to test

Contact Info

Product

Resources

About