Hidalgo Santos Antonio David, de Mingo Alemany María Del Carmen, Moreno Macián Francisca, León Cariñena Sara, Collado Ballesteros Erika, Cañete Nieto Adela
Unidad de Endocrinología Infantil, Hospital Universitario y Politécnico La Fe, Valencia, España.
Servicio de Oncología Radioterápica, Hospital Universitario y Politécnico La Fe, Valencia, España.
Rev Chil Pediatr. 2019 Dec;90(6):598-605. doi: 10.32641/rchped.v90i6.994.
Radiation therapy, chemotherapy, and surgery used to treat brain tumors have effects on the hy pothalamic-pituitary-adrenal axis and can result in endocrine dysfunction in up to 96% of cases.
Retrospective and descriptive study in patients diagnosed with medulloblasto ma 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.
Total sample of 23 patients. Growth hormone deficiency is the most frequent sequelae (82%) fo llowed 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.
Long-term follow- up 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.
用于治疗脑肿瘤的放射疗法、化学疗法和手术会影响下丘脑 - 垂体 - 肾上腺轴，高达96%的病例会导致内分泌功能障碍。
对一家三级医院过去20年中诊断为髓母细胞瘤并接受化疗和放疗的患者进行回顾性和描述性研究。分析的变量包括年龄、性别、体重、身高、随访结束时的体重指数（BMI）、性成熟阶段、促甲状腺激素（TSH）和游离甲状腺素（T4）、促肾上腺皮质激素（ACTH）/皮质醇和胰岛素样生长因子 -1（IGF-1）、促卵泡激素（FSH）、促黄体生成素（LH）、雌二醇、睾酮、血脂谱（总胆固醇）以及生长激素动态功能测试。
共23例患者。生长激素缺乏是最常见的后遗症（82%），其次是甲状腺功能障碍（44.8%）和青春期紊乱（24.1%）。仅诊断出1例尿崩症和2例促肾上腺皮质激素缺乏症。
对接受化疗和放疗的髓母细胞瘤幸存者进行长期随访发现，内分泌功能障碍的患病率非常高，尤其是生长激素缺乏和甲状腺功能减退。我们认为，对这些患者进行监测和长期随访对于确保对那些可治疗的功能障碍进行充分的治疗管理是必要的。
