Arslanian S A, Becker D J, Lee P A, Drash A L, Foley T P
Am J Dis Child. 1985 Apr;139(4):347-50. doi: 10.1001/archpedi.1985.02140060029020.
We report the outcome of growth hormone (GH) therapy in 34 children (17 boys and 17 girls) with brain tumors in whom hypopituitarism developed. The types of tumors included the following: craniopharyngiomas (18); germinomas (four); astrocytomas (three); chromophobe adenomas (three); medulloblastomas (two); glioma (one); dermoid (one); retinoblastoma (one); and metastatic rhabdomyosarcoma from the pelvis (one). Ninety-four percent of the patients were GH deficient post-tumor therapy, which consisted of surgery with and without radiotherapy. Twenty-four of 34 patients received GH. Eight of 24 patients receiving GH had recurrence of tumor; 16 were tumor free eight to 72 months after initial therapy. Eleven patients had 12 recurrences. Patients with tumor recurrence had a considerably lower growth rate during the first year of GH therapy than those without recurrence (mean, 3.5 +/- 1.3 cm/yr v 6.2 +/- 2.5 cm/yr). Three of 11 patients with recurrence had not received GH therapy; however, one was receiving testosterone intramuscularly monthly at the time of a second recurrence. Thus, 24 of 34 patients with brain tumors and hypopituitarism received GH therapy. Eight (33%) of 24 had tumor recurrence, compared with three (30%) of ten who did not receive GH. The data suggest that GH therapy is probably not associated with increased rate of tumor recurrence.
我们报告了34例发生垂体功能减退的脑肿瘤患儿（17名男孩和17名女孩）生长激素（GH）治疗的结果。肿瘤类型包括：颅咽管瘤（18例）；生殖细胞瘤（4例）；星形细胞瘤（3例）；嫌色性腺瘤（3例）；髓母细胞瘤（2例）；神经胶质瘤（1例）；皮样囊肿（1例）；视网膜母细胞瘤（1例）；以及来自骨盆的转移性横纹肌肉瘤（1例）。94%的患者在肿瘤治疗后出现生长激素缺乏，肿瘤治疗包括手术，部分患者还接受了放疗。34例患者中有24例接受了生长激素治疗。接受生长激素治疗的24例患者中有8例肿瘤复发；16例在初始治疗后8至72个月无肿瘤复发。11例患者出现了12次复发。肿瘤复发的患者在生长激素治疗的第一年生长速度明显低于未复发的患者（平均，3.5±1.3厘米/年对6.2±2.5厘米/年）。11例复发患者中有3例未接受生长激素治疗；然而，其中1例在第二次复发时每月接受一次肌肉注射睾酮治疗。因此，34例脑肿瘤伴垂体功能减退的患者中有24例接受了生长激素治疗。24例中有8例（33%）出现肿瘤复发，未接受生长激素治疗的10例中有3例（30%）复发。数据表明，生长激素治疗可能与肿瘤复发率增加无关。
