Growth hormone therapy and tumor recurrence. Findings in children with brain neoplasms and hypopituitarism
S. A. Arslanian, D. J. Becker, P. A. Lee, A. L. Drash and T. P. Foley Jr
We report the outcome of growth hormone (GH) therapy in 34 children (17
boys and 17 girls) with brain tumors in whom hypopituitarism developed. The
types of tumors included the following: craniopharyngiomas (18); germinomas
(four); astrocytomas (three); chromophobe adenomas (three);
medulloblastomas (two); glioma (one); dermoid (one); retinoblastoma (one);
and metastatic rhabdomyosarcoma from the pelvis (one). Ninety-four percent
of the patients were GH deficient post-tumor therapy, which consisted of
surgery with and without radiotherapy. Twenty-four of 34 patients received
GH. Eight of 24 patients receiving GH had recurrence of tumor; 16 were
tumor free eight to 72 months after initial therapy. Eleven patients had 12
recurrences. Patients with tumor recurrence had a considerably lower growth
rate during the first year of GH therapy than those without recurrence
(mean, 3.5 +/- 1.3 cm/yr v 6.2 +/- 2.5 cm/yr). Three of 11 patients with
recurrence had not received GH therapy; however, one was receiving
testosterone intramuscularly monthly at the time of a second recurrence.
Thus, 24 of 34 patients with brain tumors and hypopituitarism received GH
therapy. Eight (33%) of 24 had tumor recurrence, compared with three (30%)
of ten who did not receive GH. The data suggest that GH therapy is probably
not associated with increased rate of tumor recurrence.
