Cicognani A, Cacciari E, Carlá G, Rosito P, Cau M, Mancini A F, Zucchini S, Vecchi V, Pirazzoli P, Paolucci G
First Pediatric Clinic, University of Bologna, Italy.
Am J Dis Child. 1992 Nov;146(11):1343-8. doi: 10.1001/archpedi.1992.02160230101028.
To determine the effects of 18-Gy cranial irradiation on growth, growth hormone (GH) secretion, and pituitary magnetic resonance imaging in children who underwent previous irradiation for treatment of acute lymphoblastic leukemia.
Clinical survey.
Department of Pediatrics of the University of Bologna (Italy).
Ten boys and 18 girls who were treated for acute lymphoblastic leukemia; median age at diagnosis was 3.1 years and at the end of follow-up was 11.5 years.
Height was periodically measured from diagnosis until the end of follow-up, when GH secretion study and magnetic resonance imaging were performed. The mean height SD score was significantly lower than at diagnosis only at the end of treatment. Nocturnal mean GH concentration and GH response to pharmacological tests (arginine and levodopa [L-dopa]) were pathological in 22 cases (81.5%) and 18 cases (64.3%), respectively. Sixteen cases (59.2%) had a blunted GH release to the three tests. Mean pituitary anterior lobe height was reduced and seven subjects (25%) showed an empty sella.
Cranial irradiation with 18 Gy does not seem to influence the growth pattern of most children who are treated for acute lymphoblastic leukemia, despite severe impairment of GH secretion and morphological abnormalities of the sellar area. However, a follow-up until final height is necessary.
确定18 Gy颅脑照射对既往接受过急性淋巴细胞白血病治疗的儿童生长、生长激素（GH）分泌及垂体磁共振成像的影响。
临床调查。
意大利博洛尼亚大学儿科学系。
10名男孩和18名女孩，均接受过急性淋巴细胞白血病治疗；诊断时的中位年龄为3.1岁，随访结束时为11.5岁。
从诊断开始直至随访结束定期测量身高，随访结束时进行GH分泌研究及磁共振成像检查。仅在治疗结束时，平均身高标准差评分显著低于诊断时。夜间平均GH浓度及GH对药物试验（精氨酸和左旋多巴）的反应分别在22例（81.5%）和18例（64.3%）中呈病理性。16例（59.2%）对三项试验的GH释放反应减弱。垂体前叶平均高度降低，7名受试者（25%）显示为空蝶鞍。
18 Gy的颅脑照射似乎并未影响大多数接受急性淋巴细胞白血病治疗儿童的生长模式，尽管其GH分泌严重受损且蝶鞍区存在形态学异常。然而，有必要随访至最终身高。
