Late effects following central nervous system radiation in a pediatric population

V N Avizonis1, D B Fuller, J W Thomson

  • 1LDS Hospital, SLC, UT.

Neuropediatrics
|October 1, 1992
PubMed

Insights

Radiation therapy for childhood central nervous system malignancies can impact growth and endocrine function. Higher radiation doses, particularly to the pituitary, are linked to decreased height and increased endocrine deficiencies in pediatric patients.

Area of Science:

  • Pediatric Oncology
  • Radiation Oncology
  • Neuro-oncology

Background:

  • Central nervous system (CNS) malignancies are a significant concern in pediatric oncology.
  • Radiation therapy has been a cornerstone treatment for various pediatric CNS tumors.
  • Long-term effects of radiation on growth, endocrine function, and neurocognition require careful evaluation.

Purpose of the Study:

  • To assess the late effects of radiation therapy on growth, endocrine function, IQ, and hair regrowth in children treated for CNS malignancy.
  • To identify specific treatment parameters, such as radiation dose and location, associated with adverse outcomes.

Main Methods:

  • Retrospective analysis of 120 children treated with radiation therapy for CNS malignancy between 1970 and 1986.
  • Evaluation of growth, endocrine function (including somatomedin-C levels), IQ, and hair regrowth in a subset of 51 patients.
  • Correlation of late effects with radiation dose, treatment volume, tumor histology, and patient demographics.

Main Results:

  • Mean height was 1.5 standard deviations below the mean, with significant reductions in patients receiving pituitary radiation or with somatomedin-C deficiency.
  • Pituitary radiation increased the likelihood of endocrine deficiency (p=0.004); 21/51 patients had somatomedin-C deficiency.
  • Mean IQ was 92.7, with a trend toward decreased IQ correlating with higher whole-brain radiation doses. Hair regrowth was diminished with increased radiation volume and dose.

Conclusions:

  • Radiation therapy for pediatric CNS malignancies is associated with significant long-term effects on growth and endocrine function.
  • Pituitary radiation dose is a critical factor in endocrine dysfunction.
  • While IQ and hair regrowth may also be affected, these outcomes appear less sensitive to specific treatment parameters compared to growth and endocrine function.