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Predictors of Response to Growth Hormone Treatment and Final Height in Medulloblastoma Survivors
Eve Zipporah Stern1,2, Michal Ben-Ami3,4, Yael Levy-Shraga3,4
1Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel, zipporaheve.stern@sheba.health.gov.il.
Introduction:
Abnormal growth patterns and impaired final height (FH) are well-recognized long-term complications of childhood medulloblastoma; however, data regarding response to growth hormone treatment (GHT) and determinants of FH are scarce. We aim to describe growth characteristics and response to GHT in survivors of childhood medulloblastoma, and to identify factors associated with FH outcome.
Methods:
A retrospective study comprising all pediatric patients treated for medulloblastoma in a tertiary care center between 1987 and 2023 and followed up for at least 1 year following diagnosis.
Results:
A total of 65/67 patients included in the final analysis (97%) exhibited growth retardation, of whom 38 (58%) were diagnosed with GH deficiency, and 26 were treated with GH. Fifteen of the GH-treated patients achieved FH, with a mean FH-SDS of -1.42 ± 1.47. Only eight (53%) achieved FH within the normal range. FH-SDS of survivors not treated with GH (-1.72 ± 1.25) was lower than that of GH-treated survivors, but this difference did not reach statistical significance. The most important predictor of FH outcome in GH-treated patients was height-SDS at initiation of treatment.
Conclusion:
Growth retardation and GH deficiency are observed in the vast majority of medulloblastoma patients. Our results suggest that early identification and treatment of GH deficiency are crucial for optimization of FH outcome. Long-term safety of GHT is still a concern and should be discussed with the family prior to initiating treatment.
