von Elmar Kirches ; Felix Sahm ; Andrey Korshunov ; Christina Bluecher ; Natalie Waldt ; Siegfried Kropf ; Daniel Schrimpf ; Philipp Sievers ; Damian Stichel ; Ulrich Schüller ; Jens Florian Schittenhelm ; Markus Johannes Riemenschneider ; Matthias A. Karajannis ; Arie Perry ; Torsten Pietsch ; Svenja Boekhoff ; David Capper ; Katja Beck ; Nagarajan Paramasivam ; Matthias Schlesner ; Priscilla K. Brastianos ; Hermann L. Müller ; Stefan Pfister ; Christian Mawrin
<section class="abstract"><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d216e3">Objective</h3><p>Quality of survival, prognosis and long-term outcome are often severely impaired in childhood-onset craniopharyngioma (CP) patients. Identification of risk factors for sequelae such as growth hormone (GH) deficiency is important for appropriate treatment and rehabilitation.</p></div><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d216e6">Design</h3><p>In a cross-sectional study, 79 CP patients recruited in HIT-Endo before 2000 were analyzed according to GH substitution: (a) CP never GH treated (noGH); (b) CP GH treated only during childhood (pedGH); (c) CP under GH, initiated at adulthood (adultGH); (d) CP under GH during childhood and continued during adulthood (contGH).</p></div><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d216e9">Methods</h3><p>Progression-free (PFS) and overall survival (OS), height, BMI, psychosocial and neuropsychological status (EORTC QLQ-C30, MFI-20).</p></div><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d216e12">Results</h3><p>OS and PFS rates were similar in all subgroups. ContGH and pedGH CP presented with increases in height (<em>P</em>=0.002; <em>P</em>=0.0001) during long-term follow-up when compared with baseline. In all subgroups except for pedGH, increases in BMI were observed when compared with BMI at diagnosis. For emotional functionality and physical fatigue, adultGH CP showed worse (<em>P</em>=0.037; <em>P</em>=0.034) response (mean: 61.4%; 12.5%) when compared with pedGH CP (mean: 83.5%; 7.7%). Observed differences were not related to irradiation and hypothalamic involvement. In terms of psychosocial status, no differences were observed between subgroups.</p></div><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d216e28">Conclusions</h3><p>We conclude that GH substitution was safe with regard to risk of tumor progression/relapse in CP. Growth was improved by GH, whereas the development of obesity was not influenced by GH substitution. However, early initiation of GH substitution after CP diagnosis might have beneficial effects on weight development and neuropsychological outcome.</p></div></section>
European journal of endocrinology Bristol : BioScientifica Ltd., 1948 179(2018), 5, Seite 331-341 Online-Ressource