Growth hormone replacement therapy in children with medulloblastoma: Use and effect on tumor control
Growth hormone replacement therapy in children with medulloblastoma: Use and effect on tumor control
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DOI：
10.1200/jco.2001.19.2.480
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发表时间：
2001-01-15
影响因子：
45.3
通讯作者：
Moshang, T
中科院分区：
文献类型：
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作者：
Packer, RJ;Boyett, JM;Moshang, T
目的：髓母细胞瘤是最常见的儿童恶性脑肿瘤，其治疗已取得进展：然而，许多长期存活者会出现治疗后生长激素不足，导致线性生长迟缓。生长激素替代疗法（GHRT）可显著改善生长，但由于担心肿瘤复发的可能性增加，通常不愿意启动GHRT。本研究回顾性分析了GHRT在11例神经母细胞瘤幸存者中的应用，在1980年至1993年期间接受疾病初步治疗的北美肿瘤中心，以确定其对疾病控制的影响。一个地标分析被用来评估复发的相对风险存活patients.Results：五百四十五个连续的患者小于15岁的诊断确定。诊断时小于3岁的儿童的6年无进展生存率（平均值+/- SD）为40% +/- 5%，而老年患者为59% +/- 3%。全切除或近全切除（P = 0.003）和诊断时局限性病变（P
Purpose: Progress has been made in the treatment of medulloblastoma, the most common childhood malignant brain tumor: However, many long-term survivors will have posttherapy growth hormone insufficiency with resultant linear growth retardation. Growth hormone replacement therapy (GHRT) may significantly improve growth, but there is often reluctance to initiate GHRT because of concerns of an increased likelihood of tumor relapse.Patients and Methods: This study retrospectively reviewed the use of GHRT for survivors of medulloblastoma in 11 neuro-oncology centers in North America who received initial treatment for disease between 1980 and 1993 to determine its impact on disease control. A Landmark analysis was used to evaluate the relative risk of relapse in surviving patients.Results: Five hundred forty-five consecutive patients less than 15 years of age at diagnosis were identified. Six-year progression-free survival (mean +/- SD) was 40% +/- 5% in children less than 3 years of age at diagnosis compared with 59% +/- 3% for older patients. Older patients with total or near-total resections (P =.003) and localized disease at diagnosis (P