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Dosimetry and growth hormone deficiency following cranial irradiation of childhood brain tumors

Schmiegelow, Marianne; Lassen, Sören; Weber, Lars LU ; Skovgaard-Poulsen, Hans; Hertz, Henrik and Müller, Joern (1999) In Medical and Pediatric Oncology 33(6). p.564-571
Abstract
Background. Dosimetry of the hypothalamus-pituitary (HP) region could allow prediction of the risk of growth hormone deficiency (GHD) following cranial irradiation.

Procedure. Nineteen children (15 boys) with a median age of 6.3 years (range 1.7–16.5) at the time of irradiation of a brain tumor not involving the HP axis were followed for 1.2–6.3 years (median 3.4) from radiotherapy (RT). The dose to a standardized anatomical model including the HP region was calculated from dose volume histograms of 10% to 100% in steps of 10% of the HP model based on data from a computer-based treatment planning system. If GHD was suspected from insulin-like growth factor-I, serum insulin-like growth factor binding protein-3, and/or height... (More)
Background. Dosimetry of the hypothalamus-pituitary (HP) region could allow prediction of the risk of growth hormone deficiency (GHD) following cranial irradiation.

Procedure. Nineteen children (15 boys) with a median age of 6.3 years (range 1.7–16.5) at the time of irradiation of a brain tumor not involving the HP axis were followed for 1.2–6.3 years (median 3.4) from radiotherapy (RT). The dose to a standardized anatomical model including the HP region was calculated from dose volume histograms of 10% to 100% in steps of 10% of the HP model based on data from a computer-based treatment planning system. If GHD was suspected from insulin-like growth factor-I, serum insulin-like growth factor binding protein-3, and/or height velocity measurements, an arginine stimulation test was performed. GHD was defined by a peak GH <15mU/liter.

Results. Ten patients developed GHD 10–26 months from irradiation. Cox regression analysis identified the 90% dose volume of the HP box as the strongest predictor of development of GHD (P = 0.03). The median dose to the 90% dose-volume of the HP region was 37.5 Gy (range 2.3–55.3). The cumulated risk of GHD 2.5 years after radiotherapy for children receiving more than and less than 37.5 Gy to the HP region was 87% and 33%, respectively (P = 0.036).

Conclusions. Dosimetry of a defined HP volume provides the opportunity to 1) calculate the exact dose delivered to this region, 2) predict the risk of GHD and, 3) in the future revise the treatment planning and thus reduce the risk of endocrine adverse effects. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
radiotherapy, late effects, childhood cancer, dosimetry, growth hormone deficiency, insulin-like growth factor
in
Medical and Pediatric Oncology
volume
33
issue
6
pages
564 - 571
publisher
John Wiley & Sons
external identifiers
  • Scopus:0032737354
ISSN
1096-911X
language
English
LU publication?
no
id
b62cfd95-32b4-4bd9-a489-fa02d9d90a78 (old id 1549145)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/10573581
http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1096-911X(199912)33:6%3C564::AID-MPO8%3E3.0.CO;2-N/abstract
date added to LUP
2013-07-31 15:42:13
date last changed
2016-10-13 04:42:30
@misc{b62cfd95-32b4-4bd9-a489-fa02d9d90a78,
  abstract     = {Background. Dosimetry of the hypothalamus-pituitary (HP) region could allow prediction of the risk of growth hormone deficiency (GHD) following cranial irradiation.<br/><br>
Procedure. Nineteen children (15 boys) with a median age of 6.3 years (range 1.7–16.5) at the time of irradiation of a brain tumor not involving the HP axis were followed for 1.2–6.3 years (median 3.4) from radiotherapy (RT). The dose to a standardized anatomical model including the HP region was calculated from dose volume histograms of 10% to 100% in steps of 10% of the HP model based on data from a computer-based treatment planning system. If GHD was suspected from insulin-like growth factor-I, serum insulin-like growth factor binding protein-3, and/or height velocity measurements, an arginine stimulation test was performed. GHD was defined by a peak GH &lt;15mU/liter.<br/><br>
Results. Ten patients developed GHD 10–26 months from irradiation. Cox regression analysis identified the 90% dose volume of the HP box as the strongest predictor of development of GHD (P = 0.03). The median dose to the 90% dose-volume of the HP region was 37.5 Gy (range 2.3–55.3). The cumulated risk of GHD 2.5 years after radiotherapy for children receiving more than and less than 37.5 Gy to the HP region was 87% and 33%, respectively (P = 0.036).<br/><br>
Conclusions. Dosimetry of a defined HP volume provides the opportunity to 1) calculate the exact dose delivered to this region, 2) predict the risk of GHD and, 3) in the future revise the treatment planning and thus reduce the risk of endocrine adverse effects.},
  author       = {Schmiegelow, Marianne and Lassen, Sören and Weber, Lars and Skovgaard-Poulsen, Hans and Hertz, Henrik and Müller, Joern},
  issn         = {1096-911X},
  keyword      = {radiotherapy,late effects,childhood cancer,dosimetry,growth hormone deficiency,insulin-like growth factor},
  language     = {eng},
  number       = {6},
  pages        = {564--571},
  publisher    = {ARRAY(0x9b84158)},
  series       = {Medical and Pediatric Oncology},
  title        = {Dosimetry and growth hormone deficiency following cranial irradiation of childhood brain tumors},
  volume       = {33},
  year         = {1999},
}