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Hypothalamic-pituitary dysfunction in survivors of childhood brain tumors in Prasat Neurological Institute

Apasri Lusawat1, Kanlaya Dhiravibulya, Sasipa Thammongkol

  • 1Department ofPediatric Neurology, Prasat Neurological Institute, Bangkok, Thailand. lusawat@hotmail.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|March 4, 2010
PubMed

Insights

Childhood brain tumor survivors frequently experience hypothalamic-pituitary dysfunction, impacting growth hormone and adrenal function. Regular monitoring is crucial for managing these endocrine issues and improving survivors' quality of life.

Area of Science:

  • Pediatric Endocrinology
  • Neuro-oncology
  • Clinical Research

Background:

  • Childhood brain tumors pose significant long-term health challenges.
  • Survivors often develop endocrine complications due to treatment and tumor location.
  • Hypothalamic-pituitary dysfunction is a common sequela requiring careful assessment.

Purpose of the Study:

  • To evaluate the prevalence and types of hypothalamic-pituitary dysfunction in childhood brain tumor survivors.
  • To compare dysfunction between tumors directly and indirectly affecting the hypothalamic-pituitary axis.
  • To inform clinical monitoring and management strategies for these survivors.

Main Methods:

  • A cohort of 19 childhood brain tumor survivors, at least 2 years post-treatment without recurrence, was studied.
  • Patients were classified as directly (DHPA) or indirectly (IDHPA) involving the hypothalamic-pituitary axis.
  • Hormonal assessments included Growth Hormone (GH) stimulation tests, ACTH stimulation tests, and thyroid function tests (TFTs).

Main Results:

  • 73% of survivors exhibited Growth Hormone Deficiency (GHD).
  • High rates of adrenal insufficiency (85% DHPA, 10% IDHPA) and central hypothyroidism (100% DHPA, 10% IDHPA) were observed.
  • Tumor location directly impacting the axis (DHPA) correlated with more severe dysfunction.

Conclusions:

  • Childhood brain tumor survivors, particularly those with DHPA, are at high risk for significant hypothalamic-pituitary dysfunction.
  • Regular endocrine monitoring is essential for early detection and management.
  • Proactive management can mitigate morbidity and enhance the quality of life for survivors.
Abstract

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