Endocrinological late effects of oncologic treatment on survivors of medulloblastoma

Abstract

Radiation therapy, chemotherapy, and surgery used to treat brain tumors have effects on the hypothalamic-pituitary-adrenal axis and can result in endocrine dysfunction in up to 96% of cases.

Patients and Method: Retrospective and descriptive study in patients diagnosed with medulloblastoma who underwent treatment with chemo and radiotherapy in the last 20 years in a tertiary hospital. The variables analyzed were age, sex, weight, height, body mass index (BMI) at the end of follow-up, sexual maturity stage, serum levels of TSH and free T4, ACTH/cortisol and IGF-1, FSH, LH, estradiol, testosterone, lipid profile (total cholesterol), and growth hormone dynamic function test.

Results: Total sample of 23 patients. Growth hormone deficiency is the most frequent sequelae (82%) followed by thyroid dysfunction (44.8%), and disorders of puberty (24.1%). Only one case of diabetes insipidus and two cases of corticotropin deficiency were diagnosed.

Conclusions: Long-term followup of medulloblastoma survivors treated with chemo and radiotherapy reveals a very high prevalence of endocrine dysfunction, especially growth hormone deficiency and hypothyroidism. We believe that monitoring and long-term follow-up of these patients is necessary in order to ensure adequate therapeutic management of those treatable dysfunctions.