NIAGARA-ON-THE-LAKE, Ontario, CanadaSurvivors of childhood brain tumors
appear to have a high risk for non-neurological late effects such as
endocrine disorders, according to a report (abstract 7) presented at the 7th
International Conference for Long-Term Complications of Treatment of Children
and Adolescents for Cancer, hosted by Roswell Park Cancer Institute.
This increased risk was found in survivors no matter what their treatment,
although the risks were higher in patients who received both radiation
therapy and chemotherapy.
"We looked at problems that manifested themselves 5 years postdiagnosis,"
said Leslie Robison, PhD, director, Division of Pediatric Epidemiology and
Clinical Research, University of Minnesota. "This project is an overall first
pass at looking at these outcomes after brain tumor treatment. We are
continuing to follow this group."
This study compared 1,607 brain tumor survivors who participated in the
Childhood Cancer Survivor Study with 3,418 cancer-free siblings.
The brain tumor survivors reported substantially higher rates than
siblings of hypothyroidism [relative risk (RR) 14.3], growth hormone
deficiency (RR 278), medications needed to reach puberty (RR 86), stroke (RR
42.8), and osteoporosis (RR 24.7). Rates of diabetes mellitus were similar
between the groups.
The cohort received the following treatments26% surgery alone, 42%
surgery and radiation therapy, 28% surgery, radiation therapy, and
chemotherapy, and 4% radiation therapy or chemotherapy or both.
Among the survivors, after controlling for histology, sex, and age at
diagnosis, radiation therapy increased the risk of a non-neurological
outcome, compared with surgery alone. Risks were even greater for those
survivors who also received chemotherapy.