Bo Li1,2, Jiayi Wang1, Jiongxian Yang3, Yanong Li1, Yanwei Liu1, Shuai Liu1, Xiaoguang Qiu4,5. 1. Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. 2. Beijing Neurosurgery Institute, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. 3. Department of Clinical Nutrition, Beijing Children's Hospital, Capital Medical University, No. 56, Nanli shilu, Xicheng District, Beijing, 100045, China. 4. Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. qiuxiaoguang@bjtth.org. 5. Beijing Neurosurgery Institute, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. qiuxiaoguang@bjtth.org.
Abstract
PURPOSE: To explore the characteristics of growth disturbance in patients with intracranial germinoma with different origins. METHODS: Clinical data of 151 patients with single-origin germinomas were studied retrospectively. Z-score of height (ZSOH) at both diagnosis and the last follow-up was calculated using the WHO AnthroPlus software. Linear regression was used to analyse the correlation between the absolute change in ZSOH (|ZSOH last follow-up - ZSOH diagnosis|) and clinical factors. RESULTS: The mean ZSOH decreased significantly in every origin subgroup at the last follow-up. In patients with sellar germinoma (n = 62), the mean ZSOH values at both diagnosis and the last follow-up were significantly lower than those in patients with pineal (n = 30) (p < 0.001) or basal ganglia germinomas (n = 59) (p < 0.001), respectively. In patients with basal ganglia germinoma, the mean absolute change in ZSOH decreased significantly compared to that in the patients with sellar (p = 0.006) or pineal germinomas (p = 0.04). Linear analysis revealed that sex (male vs female; p = 0.003) and age at diagnosis (≤10 years vs >10 years; p = 0.026) had negative correlations, while radiation dose at the hypothalamic-pituitary axis (HPA) (≤40 Gy vs >40 Gy; p = 0.085) had a marginally positive correlation, with absolute change in ZSOH. CONCLUSIONS: Patients with germinoma experienced growth retardation after treatments. The growth disturbance was consistent and more severe in patients with germinoma of sellar origin, while the greatest aggravation was observed in patients with germinoma of basal ganglia origin. Decreasing radiation dose to the HPA may minimize the negative impact of radiotherapy on growth.
PURPOSE: To explore the characteristics of growth disturbance in patients with intracranial germinoma with different origins. METHODS: Clinical data of 151 patients with single-origin germinomas were studied retrospectively. Z-score of height (ZSOH) at both diagnosis and the last follow-up was calculated using the WHO AnthroPlus software. Linear regression was used to analyse the correlation between the absolute change in ZSOH (|ZSOH last follow-up - ZSOH diagnosis|) and clinical factors. RESULTS: The mean ZSOH decreased significantly in every origin subgroup at the last follow-up. In patients with sellar germinoma (n = 62), the mean ZSOH values at both diagnosis and the last follow-up were significantly lower than those in patients with pineal (n = 30) (p < 0.001) or basal ganglia germinomas (n = 59) (p < 0.001), respectively. In patients with basal ganglia germinoma, the mean absolute change in ZSOH decreased significantly compared to that in the patients with sellar (p = 0.006) or pineal germinomas (p = 0.04). Linear analysis revealed that sex (male vs female; p = 0.003) and age at diagnosis (≤10 years vs >10 years; p = 0.026) had negative correlations, while radiation dose at the hypothalamic-pituitary axis (HPA) (≤40 Gy vs >40 Gy; p = 0.085) had a marginally positive correlation, with absolute change in ZSOH. CONCLUSIONS:Patients with germinoma experienced growth retardation after treatments. The growth disturbance was consistent and more severe in patients with germinoma of sellar origin, while the greatest aggravation was observed in patients with germinoma of basal ganglia origin. Decreasing radiation dose to the HPA may minimize the negative impact of radiotherapy on growth.
Authors: Antonio David Hidalgo Santos; María Del Carmen de Mingo Alemany; Francisca Moreno Macián; Sara León Cariñena; Erika Collado Ballesteros; Adela Cañete Nieto Journal: Rev Chil Pediatr Date: 2019-12