TY - JOUR
T1 - GH and Childhood-onset Craniopharyngioma
T2 - When to Initiate GH Replacement Therapy?
AU - Quoc, Adrien Nguyen
AU - Beccaria, Kévin
AU - Briceño, Laura González
AU - Pinto, Graziella
AU - Samara-Boustani, Dinane
AU - Stoupa, Athanasia
AU - Beltrand, Jacques
AU - Besançon, Alix
AU - Thalassinos, Caroline
AU - Puget, Stéphanie
AU - Blauwblomme, Thomas
AU - Alapetite, Claire
AU - Bolle, Stéphanie
AU - Doz, François
AU - Grill, Jacques
AU - Dufour, Christelle
AU - Bourdeaut, Franck
AU - Abbou, Samuel
AU - Guerrini-Rousseau, Léa
AU - Leruste, Amaury
AU - Brabant, Séverine
AU - Cavadias, Iphigénie
AU - Viaud, Magali
AU - Boddaert, Nathalie
AU - Polak, Michel
AU - Kariyawasam, Dulanjalee
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Context: Craniopharyngioma is a benign brain tumor with frequent local recurrence or progression after treatment. GH replacement therapy (GHRT) is prescribed in children with GH deficiency resulting from childhood-onset craniopharyngioma. Objective: To evaluate whether a shorter delay of GHRT initiation after childhood-onset craniopharyngioma completion therapy increased the risk of a new event (progression or recurrence). Methods: Retrospective, observational, monocenter study. We compared a cohort of 71 childhood-onset patients with craniopharyngiomas treated with recombinant human GH (rhGH). Twenty-seven patients were treated with rhGH at least 12 months after craniopharyngioma treatment (>12-month group) and 44 patients before 12 months (<12-month group), among which 29 patients were treated between 6 and 12 months (6-12 month group). The main outcome was the risk of tumor new event (progression of residual tumor or tumor recurrence after complete resection) after primary treatment in the >12-month group and in the <12 month or in the 6- to 12-month group patients. Results: In the >12-month group, the 2- and 5-year event-free survivals were respectively 81.5% (95% CI, 61.1-91.9) and 69.4% (95% CI, 47.9-83.4) compared with 72.2% (95% CI, 56.3-83.1) and 69.8% (95% CI, 53.8-81.2) in the <12-month group. The 2- and 5-year event-free survivals were the same in the 6- to 12-month group (72.4%; 95% CI, 52.4-85.1). By log-rank test, the event-free survival was not different between groups (P = .98 and P = .91). The median time for event was not statistically different. In univariate and multivariate analysis, the risk of craniopharyngioma new event was not associated with the GHRT time delay after craniopharyngioma treatment. Conclusions: No association was found between GHRT time delay after childhood-onset craniopharyngioma treatment and an increased risk of recurrence or tumor progression, suggesting GH replacement therapy can be initiated 6 months after last treatment for craniopharyngiomas.
AB - Context: Craniopharyngioma is a benign brain tumor with frequent local recurrence or progression after treatment. GH replacement therapy (GHRT) is prescribed in children with GH deficiency resulting from childhood-onset craniopharyngioma. Objective: To evaluate whether a shorter delay of GHRT initiation after childhood-onset craniopharyngioma completion therapy increased the risk of a new event (progression or recurrence). Methods: Retrospective, observational, monocenter study. We compared a cohort of 71 childhood-onset patients with craniopharyngiomas treated with recombinant human GH (rhGH). Twenty-seven patients were treated with rhGH at least 12 months after craniopharyngioma treatment (>12-month group) and 44 patients before 12 months (<12-month group), among which 29 patients were treated between 6 and 12 months (6-12 month group). The main outcome was the risk of tumor new event (progression of residual tumor or tumor recurrence after complete resection) after primary treatment in the >12-month group and in the <12 month or in the 6- to 12-month group patients. Results: In the >12-month group, the 2- and 5-year event-free survivals were respectively 81.5% (95% CI, 61.1-91.9) and 69.4% (95% CI, 47.9-83.4) compared with 72.2% (95% CI, 56.3-83.1) and 69.8% (95% CI, 53.8-81.2) in the <12-month group. The 2- and 5-year event-free survivals were the same in the 6- to 12-month group (72.4%; 95% CI, 52.4-85.1). By log-rank test, the event-free survival was not different between groups (P = .98 and P = .91). The median time for event was not statistically different. In univariate and multivariate analysis, the risk of craniopharyngioma new event was not associated with the GHRT time delay after craniopharyngioma treatment. Conclusions: No association was found between GHRT time delay after childhood-onset craniopharyngioma treatment and an increased risk of recurrence or tumor progression, suggesting GH replacement therapy can be initiated 6 months after last treatment for craniopharyngiomas.
KW - growth hormone
KW - growth hormone safety
KW - pediatric craniopharyngioma
KW - tumor recurrence
UR - http://www.scopus.com/inward/record.url?scp=85164843108&partnerID=8YFLogxK
U2 - 10.1210/clinem/dgad079
DO - 10.1210/clinem/dgad079
M3 - Article
C2 - 36794424
AN - SCOPUS:85164843108
SN - 0021-972X
VL - 108
SP - 1929
EP - 1936
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 8
ER -