The effects of adjuvant chemotherapy on growth in children with medulloblastoma
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J S Olshan1, J Gubernick, R J Packer
1Division of Endocrinology, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia.
Background:
Current therapy for children with medulloblastoma includes craniospinal radiation therapy (CSRT) with or without adjuvant chemotherapy. The difference in growth of children after the two different therapeutic modalities is unknown.
Methods:
The growth of 38 prepubertal children who survived medulloblastoma was reviewed retrospectively. Fifteen of these patients received CSRT alone; 23 received chemotherapy in addition to the radiation therapy.
Results:
The average growth velocity of all patients with medulloblastoma during the 4 years of the study was below the mean for age and sex in all patients except one. Most patients grew at velocities more than two standard deviations below the mean. The overall growth of children who received chemotherapy in conjunction with CSRT was significantly worse than the growth of those who received only CSRT. The children who received chemotherapy showed little or no improvement in growth velocity by year 4; those who did not receive chemotherapy had some improvement.
Conclusions:
These findings suggest that chemotherapy potentiates the deleterious effects of radiation on growth.