Tselovalnikova Tatiana, Ponvilawan Ben, Pavlova Maria G, Flanagan Cynthia, Rakhra Sunpreet S, Drees Betty M
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
First Moscow State Medical University (Sechenov University), Moscow, Russia.
Endocr Oncol. 2025 Jul 8;5(1):e250025. doi: 10.1530/EO-25-0025. eCollection 2025 Jan.
To evaluate the prevalence of growth hormone deficiency in patients who underwent cranial irradiation for brain tumors.
Ovid Medline and Embase databases were used for review. Eligible studies were observational studies with brain tumor survivors who had growth hormone function evaluated after treatment at age ≥18 years. Patient data on disease prevalence were pooled using the random-effect, generic inverse variance method. The presence of publication bias was determined by Egger's test. Mann-Whitney U test, univariate and multivariate linear regression were used to determine the association and effect of covariates and growth hormone peak level.
After screening 3,355 relevant articles, seven studies were included. The pooled result showed that out of 3,489 patients who received radiation for brain tumors, regardless of age at the time of treatment, 50% developed growth hormone deficiency (95% CI 40-60%, = 83%). Subgroup analysis based on the growth hormone peak level did not show differences between different cutoffs. Univariate linear regression using data from 27 patients showed that age at radiation and the time duration between radiation and the stimulation test ( = 0.03 and 0.002, respectively), but not radiation dose or sex, were significantly correlated with growth hormone peak level. After multivariate adjustment, only the time duration between radiation and the stimulation test was associated with decreased growth hormone peak level ( = 0.04).
Half of brain tumor survivors develop growth hormone deficiency. A longer duration of follow-up is associated with higher risks of growth hormone deficiency. Lifelong follow-up is essential.
评估因脑肿瘤接受颅脑照射的患者中生长激素缺乏症的患病率。
检索Ovid Medline和Embase数据库进行综述。纳入的合格研究为对年龄≥18岁的脑肿瘤幸存者在治疗后进行生长激素功能评估的观察性研究。使用随机效应、通用逆方差法汇总患者疾病患病率数据。通过Egger检验确定是否存在发表偏倚。采用Mann-Whitney U检验、单变量和多变量线性回归来确定协变量与生长激素峰值水平之间的关联及效应。
在筛选的3355篇相关文章中，纳入了7项研究。汇总结果显示，在3489例接受脑肿瘤放疗的患者中，无论治疗时的年龄如何，50%出现了生长激素缺乏症（95%可信区间40 - 60%，I² = 83%）。基于生长激素峰值水平的亚组分析未显示不同临界值之间存在差异。对27例患者的数据进行单变量线性回归分析显示，放疗时的年龄以及放疗与刺激试验之间的时间间隔（分别为P = 0.03和0.002）与生长激素峰值水平显著相关，而放疗剂量或性别则无相关性。多变量调整后，只有放疗与刺激试验之间的时间间隔与生长激素峰值水平降低有关（P = 0.04）。
一半的脑肿瘤幸存者会出现生长激素缺乏症。随访时间越长，生长激素缺乏症的风险越高。终身随访至关重要。
