儿童头颈部肿瘤幸存者的垂体和生长障碍:一项单中心研究

Shaymaa Raafat, OmneyaM Omar, Dotto Aron, RehamA Haleem Abo Elwafa, ShadyH Fadel
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摘要

目的探讨小儿脑颈部肿瘤幸存者垂体及生长障碍的患病率及危险因素。方法对203例经肿瘤治疗后存活2年的脑、颈部肿瘤患儿进行分析。报告了人口统计数据、人体测量评估、肿瘤特征、肿瘤治疗方式和激素谱评估。结果平均随访4.77年,62例(30.54%)幸存者被诊断患有至少一种垂体疾病。17.28%的幸存者存在生长激素缺乏症(GHD),而促甲状腺激素缺乏症(TSHD)、促黄体生成素和促卵泡激素缺乏症(LH/FSHD)、促肾上腺皮质激素缺乏症(ACTHD)/皮质醇缺乏症和中性性早熟分别占幸存者的10.4%、9.09、8.06和1.69%。在数据收集期间参加随访诊所的幸存者中,身材矮小和肥胖的患病率分别为9.1%和17.05%。发生垂体疾病的风险与颅咽管瘤组织学相关(OR, 6.207;95% CI, 1.025-37.581)和癌症诊断时有脑积水史(OR, 3.075;95% ci, 1.402-6.746)。放疗时年龄越大,发生垂体疾病的风险越低(OR, 0.928;95% ci, 0.864-0.997)。结论:本研究观察到儿童脑颈部肿瘤幸存者中垂体疾病的高发率。因此,对脑瘤和颈部肿瘤幸存者进行适当的垂体疾病筛查是有必要的。
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Pituitary and growth disorders of pediatric survivors of head and neck tumors: a single center study
Objective The aim was to explore the prevalence and risk factors for pituitary and growth disorders in pediatric brain and neck tumor survivors. Methods 203 children with brain or neck tumors that survived 2 years after tumors treatment were included. Demographic data, anthropometric assessments, characteristics of the tumors, tumor treatment modalities, and hormonal profile evaluation were reported. Results After a mean follow-up of 4.77 years, 62 (30.54%) survivors were diagnosed with at least one pituitary disorder. Growth hormone deficiency (GHD) was detected in 17.28% of survivors, moreover, thyroid-stimulating hormone deficiency (TSHD), luteinizing hormone and follicle-stimulating hormone deficiency (LH/FSHD), adrenocorticotropic hormone deficiency (ACTHD)/cortisol deficiency and central precocious puberty were detected in 10.4, 9.09, 8.06, and 1.69% of survivors, respectively. The prevalence of short stature and obesity was 9.1% and 17.05%, respectively among survivors who attended follow-up clinics during data collection. The risk of developing pituitary disorders was associated with craniopharyngioma histology (OR, 6.207; 95% CI, 1.025–37.581) and a history of hydrocephalus at cancer diagnosis (OR, 3.075; 95% CI, 1.402–6.746). Older age at the time of radiotherapy was associated with a lower risk of developing pituitary disorders (OR, 0.928; 95% CI, 0.864–0.997). Conclusion This study observed a high prevalence of pituitary disorders among survivors of pediatric brain and neck tumors. So proper screening of pituitary disorders in survivors of brain and neck tumors is warranted.
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