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Observational Study
. 2022 Apr 19;107(5):e2156-e2166.
doi: 10.1210/clinem/dgab893.

High Prevalence of Early Endocrine Disorders After Childhood Brain Tumors in a Large Cohort

Laura Gabriela González Briceño  1   2 , Dulanjalee Kariyawasam  1 , Dinane Samara-Boustani  1 , Elisa Giani  1 , Jacques Beltrand  1   3 , Stéphanie Bolle  4 , Brice Fresneau  5 , Stéphanie Puget  3   6 , Christian Sainte-Rose  6 , Claire Alapetite  7 , Graziella Pinto  1 , Marie-Liesse Piketty  8 , Séverine Brabant  8 , Samuel Abbou  5 , Isabelle Aerts  9 , Kevin Beccaria  6 , Marie Bourgeois  6 , Thomas Roujeau  10 , Thomas Blauwblomme  6 , Federico Di Rocco  11 , Caroline Thalassinos  1 , Christian Pauwels  1 , Charlotte Rigaud  5 , Syril James  6 , Kanetee Busiah  12 , Albane Simon  13 , Franck Bourdeaut  9 , Lauriane Lemelle  9 , Léa Guerrini-Rousseau  5   14 , Daniel Orbach  9   15 , Philippe Touraine  16 , François Doz  3   9 , Christelle Dufour  5   14 , Jacques Grill  5   14 , Michel Polak  1   3
Affiliations
Observational Study

High Prevalence of Early Endocrine Disorders After Childhood Brain Tumors in a Large Cohort

Laura Gabriela González Briceño et al. J Clin Endocrinol Metab. .

Abstract

Context: Endocrine complications are common in pediatric brain tumor patients.

Objective: We aimed to describe the endocrine follow-up of patients with primary brain tumors.

Methods: This is a noninterventional observational study based on data collection from medical records of 221 patients followed at a Pediatric Endocrinology Department.

Results: Median age at diagnosis was 6.7 years (range, 0-15.9), median follow-up 6.7 years (0.3-26.6), 48.9% female. Main tumor types were medulloblastoma (37.6%), craniopharyngioma (29.0%), and glioma (20.4%). By anatomic location, 48% were suprasellar (SS) and 52% non-suprasellar (NSS). Growth hormone deficiency (GHD) prevalence was similar in both groups (SS: 83.0%, NSS: 76.5%; P = 0.338), appearing at median 1.8 years (-0.8 to 12.4) after diagnosis; postradiotherapy GHD appeared median 1.6 years after radiotherapy (0.2-10.7). Hypothyroidism was more prevalent in SS (76.4%), than NSS (33.9%) (P < 0.001), as well as ACTH deficiency (SS: 69.8%, NSS: 6.1%; P < 0.001). Early puberty was similar in SS (16%) and NSS (12.2%). Hypogonadotropic hypogonadism was predominant in SS (63.1%) vs NSS (1.3%), P < 0.001, and postchemotherapy gonadal toxicity in NSS (29.6%) vs SS (2.8%), P < 0.001. Adult height was lower for NSS compared to target height (-1.0 SD, P < 0.0001) and to SS patients (P < 0.0001). Thyroid nodules were found in 13/45 patients (28.8%), including 4 cancers (4.8-11.5 years after radiotherapy). Last follow-up visit BMI was higher in both groups (P = 0.0001), and obesity incidence was higher for SS (46.2%) than NSS (17.4%).

Conclusion: We found a high incidence of early-onset endocrine disorders. An endocrine consultation and nutritional evaluation should be mandatory for all patients with a brain tumor, especially when the tumor is suprasellar or after hypothalamus/pituitary irradiation.

Keywords: Brain tumor; childhood cancer; endocrine disorders; non-suprasellar; suprasellar.

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