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Effect of treatment of malignant disease on growth in children
Insights
Childhood cancer treatments, particularly cranial irradiation, can temporarily impact growth. However, long-term growth hormone production appears unaffected in most patients.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Child Growth and Development
Background:
- Children undergoing treatment for malignant diseases often experience growth disturbances.
- Understanding the specific impact of different treatment modalities on pediatric growth is crucial for long-term patient outcomes.
Purpose of the Study:
- To assess the longitudinal growth patterns of children with malignant diseases.
- To compare the growth of these children with a matched cohort of healthy children.
- To identify factors influencing growth deficits during and after cancer therapy.
Main Methods:
- Studied the growth of 95 children with malignant disease over 3-4 years.
- Utilized standard deviation scores to compare patient growth against age- and sex-matched normal children.
- Analyzed the correlation between growth parameters and treatment factors like cranial irradiation, chemotherapy duration, and patient age.
Main Results:
- Children with leukemia showed a significant decrease in mean standard deviation score during the first year of treatment.
- Growth remained below normal levels subsequently, with cranial and craniospinal irradiation identified as the primary contributing factor.
- Age and chemotherapy duration did not correlate with the observed growth effects.
Conclusions:
- Cranial and craniospinal irradiation significantly impact early-stage growth in children treated for malignant diseases.
- The observed height loss is minimal, suggesting that long-term interference with growth hormone production is unlikely.
- Continued monitoring of growth trajectories in pediatric cancer survivors is essential.
Abstract:
The growth of 95 children with malignant disease was studied over a 3- or 4-year period, and compared with the growth of normal children matched for age and sex by calculation of the standard deviation score. The mean standard deviation score of the children with leukaemia fell in the first year of treatment, and thereafter showed little change, remaining below the normal. This effect was related to cranial and craniospinal irradiation, but not to age or duration of chemotherapy. The loss in eventual height attained was small and does not suggest any long-term interference with growth hormone production.