Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Beijing Neurosurgery Institute, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Childs Nerv Syst. 2021 Aug;37(8):2531-2537. doi: 10.1007/s00381-021-05189-6. Epub 2021 May 24.
To explore the characteristics of growth disturbance in patients with intracranial germinoma with different origins.
Clinical data of 151 patients with single-origin germinomas were studied retrospectively. Z-score of height (ZSOH) at both diagnosis and the last follow-up was calculated using the WHO AnthroPlus software. Linear regression was used to analyse the correlation between the absolute change in ZSOH (|ZSOH - ZSOH |) and clinical factors.
The mean ZSOH decreased significantly in every origin subgroup at the last follow-up. In patients with sellar germinoma (n = 62), the mean ZSOH values at both diagnosis and the last follow-up were significantly lower than those in patients with pineal (n = 30) (p < 0.001) or basal ganglia germinomas (n = 59) (p < 0.001), respectively. In patients with basal ganglia germinoma, the mean absolute change in ZSOH decreased significantly compared to that in the patients with sellar (p = 0.006) or pineal germinomas (p = 0.04). Linear analysis revealed that sex (male vs female; p = 0.003) and age at diagnosis (≤10 years vs >10 years; p = 0.026) had negative correlations, while radiation dose at the hypothalamic-pituitary axis (HPA) (≤40 Gy vs >40 Gy; p = 0.085) had a marginally positive correlation, with absolute change in ZSOH.
Patients with germinoma experienced growth retardation after treatments. The growth disturbance was consistent and more severe in patients with germinoma of sellar origin, while the greatest aggravation was observed in patients with germinoma of basal ganglia origin. Decreasing radiation dose to the HPA may minimize the negative impact of radiotherapy on growth.
探讨不同起源颅内生殖细胞瘤患者生长障碍的特点。
回顾性研究了 151 例单起源生殖细胞瘤患者的临床资料。使用 WHO AnthroPlus 软件计算身高 Z 评分（ZSOH）在诊断时和最后一次随访时的 Z 评分（ZSOH）。线性回归分析 ZSOH 绝对值变化（|ZSOH-ZSOH|）与临床因素的相关性。
在每个起源亚组中，最后一次随访时 ZSOH 的平均值均显著降低。在鞍内生殖细胞瘤患者（n=62）中，诊断时和最后一次随访时的 ZSOH 平均值均显著低于松果体生殖细胞瘤患者（n=30）（p<0.001）或基底节生殖细胞瘤患者（n=59）（p<0.001）。在基底节生殖细胞瘤患者中，ZSOH 的平均绝对变化与鞍内生殖细胞瘤（p=0.006）或松果体生殖细胞瘤（p=0.04）患者相比显著降低。线性分析显示，性别（男 vs 女；p=0.003）和诊断时年龄（≤10 岁 vs >10 岁；p=0.026）呈负相关，而下丘脑-垂体轴（HPA）的放射剂量（≤40 Gy vs >40 Gy；p=0.085）与 ZSOH 的绝对值变化呈边缘正相关。
生殖细胞瘤患者治疗后出现生长迟缓。起源于鞍内的生殖细胞瘤患者的生长障碍是一致且更严重的，而基底节起源的生殖细胞瘤患者的生长障碍恶化最大。减少 HPA 的放射剂量可能会最大限度地降低放疗对生长的负面影响。
