GROWTH HORMONE (hGH) THERAPY AND TUMOR RECURRENCE OF CHILDREN WITH BRAIN NEOPLASMS AND HYPOPITUITARISM

Abstract

We report on 34 children (17 males, 17 females) with brain tumors, including craniopharyngiomas (18), germinomas (4), astrocytomas (3), chromophobe adenomas (3), medulloblastomas (2), glioma (1), dermoid (1), retinoblastoma (1), and metastatic rhabdomyosarcoma from the pelvis (1). At the initiation of tumor therapy, which consisted of surgery with and without radiotherapy, mean age was 9.3 yrs. (0.4-17.8 yrs). Post tumor therapy, 94% of the patients were GH deficient. 24/34 patients received hGH. Annual growth rate before and after 1 yr. of hGH was 1.9±0.7 cm/yr and 5.6±2.8 cm/yr, respectively. 11 patients had 12 recurrences. 8 of 24 receiving hGH had recurrence of tumor within 0.5-36 mos.; 16 were tumor-free 8-72 mos. after initial therapy. Patients with tumor recurrence had a markedly lower annual growth rate during the first year of hGH than those without recurrence (mean 3.5±1.3 cm/yr vs 6.2±2.5 cm/yr, p<0.01). 3/11 patients with recurrence had not received hGH therapy; however, 1 was receiving IM testosterone monthly.In conclusion, 24 of 34 patients with brain tumors and hypopituitarism received hGH therapy. 8/24 (33%) had tumor recurrence, compared to 3/10 (30%) who did not receive hGH, and 1/10 who was receiving testosterone. The data suggest that hGH therapy is not associated with increased rate of tumor recurrence.