Assessment of Puberty and Hypothalamic-Pituitary-Gonadal Axis Function after Childhood Brain-Tumour Treatment.

Assessment of Puberty and Hypothalamic-Pituitary-Gonadal Axis Function after Childhood Brain-Tumour Treatment.
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儿童脑肿瘤治疗后青春期和下丘脑-垂体-性腺轴功能的评估。

DOI：
10.1210/clinem/dgad097
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发表时间：
2023
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
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通讯作者：
L. G. Briceno
L. G. Briceno
中科院分区：
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文献类型：
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作者：
Manon Rosimont;D. Kariyawasam;D. Samara;E. Giani;J. Beltrand;S. Bolle;B. Fresneau;S. Puget;C. Sainte‐Rose;C. Alapetite;G. Pinto;P. Touraine;M. Piketty;S. Brabant;S. Abbou;I. Aerts;K. Beccaria;M. Bourgeois;T. Roujeau;T. Blauwblomme;F. Rocco;C. Thalassinos;C. Rigaud;Syril James;K. Busiah;A. Simon;F. Bourdeaut;L. Lemelle;L. Guerrini;D. Orbach;F. Doz;C. Dufour;J. Grill;M. Polak;L. G. Briceno

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目的 描述5年前因原发性脑肿瘤接受治疗的儿童患者的下丘脑-垂体-性腺轴（HPGA）功能，以确定HPGA受损的风险因素。 方法 我们回顾性纳入了2010年1月至2015年12月期间在Necker Enfants-Malades大学医院（法国巴黎）儿科内分泌科监测的204例18岁之前诊断为原发性脑肿瘤的患者。排除垂体腺瘤或未经治疗的胶质瘤患者。 结果 在未接受放疗的鞍上胶质瘤患者中，青春期提前的患病率总体为65%，5岁以前诊断为青春期提前的患病率为70%。髓母细胞瘤化疗导致性腺毒性的所有患者中有70%，87.5%的那些小于5岁的诊断。在颅咽管瘤组中，70%的患者患有低促性腺激素性性腺功能减退症，并持续伴有生长激素缺乏症。 结论 肿瘤类型、部位和治疗是HPGA损伤的主要危险因素。意识到发病可以延迟是至关重要的指导信息的父母和病人，病人的监测，并及时激素替代治疗。
OBJECTIVE To describe hypothalamic-pituitary-gonadal axis (HPGA) function in patients treated in childhood for a primary brain tumour more than 5 years earlier, in order to identify risk factors for HPGA impairment. METHODS We retrospectively included 204 patients diagnosed with a primary brain tumour before 18 years of age and monitored at the paediatric endocrinology unit of the Necker Enfants-Malades University Hospital (Paris, France) between January 2010 and December 2015. Patients with pituitary adenoma or untreated glioma were excluded. RESULTS Among patients with suprasellar glioma not treated by radiotherapy, the prevalence of advanced puberty was 65% overall and 70% when the diagnosis occurred before 5 years of age. Medulloblastoma chemotherapy caused gonadal toxicity in 70% of all patients and 87.5% of those younger than 5 years at diagnosis. In the group with craniopharyngioma, 70% of patients had hypogonadotropic hypogonadism, which was consistently accompanied with growth hormone deficiency. CONCLUSIONS Tumour type, location, and treatment were the risk main factors for HPGA impairment. Awareness that onset can be delayed is essential to guide information of parents and patients, patient monitoring, and timely hormone replacement therapy.