Height impact of somatotropin in cancer survivors

Abstract

Somatotropin deficiency is the most common endocrinopathy in childhood cancer survivors. However, studies of final height in these patients treated with somatotropin are limited. Thus, this study was performed to examine their growth outcomes. Methods: A retrospective analysis was performed, including all childhood cancer survivors treated with somatotropin in a pediatric endocrinology department, between 1988 and 2016. Statistical analysis was performed. Results: Twenty-seven cancer survivors with a median of 5.5 years of age at diagnosis were included; 16 (59.3%) had central nervous system cancer; 19 (70.4%) were submitted to radiotherapy. Concomitant endocrinopathies existed in 14 (51.9%). Somatotropin treatment was started at a median age of 11.13 years with a median duration of 4.1 years. The initial height was −2.30 standard deviation score (SDS) and increased to −1.81 SDS by 1 year, −1.68 SDS by 2 years, and −1.56 SDS by 3 years under somatotropin treatment. There were significant differences in height between the beginning and by 1 year (p<0.001), by 1 and 2 years (p=0.006) and between initial and the end of treatment (p=0.022). However, the adult height was significantly lower than the midparental height (p=0.011), with no differences associated with gender, group of cancer, radiotherapy, concomitant endocrinopathies, age or pubertal stage at beginning. Conclusion:We concluded that the improvement of linear growth was significant, mainly in the first year of treatment, but these patients did not achieve their genetic potential for height. Physicians must be aware and search for somatotropin deficiency in cancer survivors and treatment should be started as soon as possible. R E S U M O o impacto na estatura da somatotropina em sobreviventes oncológicosIntrodução: A deficiência de somatotropina é a endocrinopatia mais comum em sobreviventes de cancro em idade pediátrica. No entanto, estudos sobre a estatura final destes doentes tratados com somatotropina são escassos, pelo que o objetivo deste estudo foi avaliar o crescimento destes doentes. Métodos: Foi realizada uma análise retrospetiva, incluindo todos os sobreviventes de cancro em idade pediátrica tratados com somatotropina numa unidade de endocrinologia pediátrica, entre 1988 e 2016. Foi realizada a análise estatística dos dados. Palavras-chave:Desenvolvimento da Criança/efeitos dos fármacos; Estatura/efeitos dos fármacos; Hormona do Crescimento/uso terapêutico; Neoplasias/complicações; Sobreviventes.