Endocrinological late effects of oncologic treatment on survivors of medulloblastoma

Rev Chil Pediatr. 2019 Dec;90(6):598-605. doi: 10.32641/rchped.v90i6.994.
[Article in English, Spanish]

Abstract

Introduction: Radiation therapy, chemotherapy, and surgery used to treat brain tumors have effects on the hy pothalamic-pituitary-adrenal axis and can result in endocrine dysfunction in up to 96% of cases.

Patients and method: Retrospective and descriptive study in patients diagnosed with medulloblasto ma who underwent treatment with chemo and radiotherapy in the last 20 years in a tertiary hospital. The variables analyzed were age, sex, weight, height, body mass index (BMI) at the end of follow-up, sexual maturity stage, serum levels of TSH and free T4, ACTH/cortisol and IGF-1, FSH, LH, estradiol, testosterone, lipid profile (total cholesterol), and growth hormone dynamic function test.

Results: Total sample of 23 patients. Growth hormone deficiency is the most frequent sequelae (82%) fo llowed by thyroid dysfunction (44.8%), and disorders of puberty (24.1%). Only one case of diabetes insipidus and two cases of corticotropin deficiency were diagnosed.

Conclusions: Long-term follow- up of medulloblastoma survivors treated with chemo and radiotherapy reveals a very high prevalence of endocrine dysfunction, especially growth hormone deficiency and hypothyroidism. We believe that monitoring and long-term follow-up of these patients is necessary in order to ensure adequate therapeutic management of those treatable dysfunctions.

MeSH terms

  • Adrenocorticotropic Hormone / deficiency
  • Cancer Survivors
  • Cerebellar Neoplasms / blood
  • Cerebellar Neoplasms / therapy*
  • Chemoradiotherapy / adverse effects*
  • Child
  • Child, Preschool
  • Diabetes Insipidus / etiology
  • Endocrine System Diseases / etiology
  • Female
  • Human Growth Hormone / deficiency
  • Humans
  • Hypogonadism / etiology
  • Male
  • Medulloblastoma / blood
  • Medulloblastoma / therapy*
  • Overweight / etiology
  • Puberty, Precocious / etiology
  • Retrospective Studies
  • Thyroid Diseases / etiology

Substances

  • Human Growth Hormone
  • Adrenocorticotropic Hormone