Abstract
We studied short- and long-term responses to growth hormone (GH) treatment and adverse medical events (AE) in 488 patients with craniopharyngioma who were entered into the Kabi International Growth Study (KIGS). First-year growth response and responsiveness (n = 394) were similar to those seen in children with idiopathic GH deficiency. The growth response over 5 years (n = 152) was unaffected by the recurrence of tumour and prior tumour management, but was greater in those receiving thyroxine. Mean height standard deviation scores (SDS) at the end of GH treatment (n = 129) was –0.7 ± 1.2, and 79% achieved a height over –2 SD of target height, with evidence of further growth potential. Final height SDS correlated positively with height SDS at the start of treatment and with target height SDS, whereas gain in height SDS was inversely correlated with height SDS and bone age at the start of GH treatment. The rate of recurrence of tumour, 0.045/treatment year, was greater in those who had been treated with surgery alone compared to surgery and cranial irradiation. Other AE included headaches, fluid retention and convulsions occurring at rates of 0.025, 0.005 and 0.004/treatment year, respectively. We concluded that GH treatment is safe and effective in children with craniopharyngioma and provide data for counselling of parents about outcome during GH treatment.
References
1.
Burns EC, Tanner JM, Preece MA, Cameron N: Growth hormone treatment in children with craniopharyngioma: Final height status. Clin Endocrinol 1981;14:587–595.
2.
Milner RDG, Russell-Fraser T, Brook GCD, Cotes PM, Farquhar JW, Parkin JM, Preece MA, Snodgrass GJAI, Stuart Mason A, Tanner JM, Vince FP: Experience with human growth hormone in Great Britain; the report of the MRC Working Party. Clin Endocrinol 1979;11:15–38.
3.
Stahnke N, Grubel G, Lagenstein I, Willig RP: Long-term follow-up of children with craniopharyngioma. Eur J Pediatr 1984;142:179–185.
4.
Price DA: Growth response in the first year of growth hormone treatment in prepubertal children with organic growth hormone deficiency: A comparison with idiopathic growth hormone deficiency. Acta Paediatr Scand Suppl 1990;130:131–137.
5.
De Vile CJ, Grant DB, Hayward RD, Stanhope R: Growth and sequelae of craniopharyngioma. Arch Dis Child 1996;75:108–114.
6.
Clayton PE, Price DA, Shalet SM, Gattamaneni HR: Craniopharyngioma recurrence and growth hormone therapy (letter). Lancet 1988;i:642.
7.
Wilton P: Rate of relapse of craniopharyngioma in children treated with growth hormone. Kabi International Growth Study 1992;report 8:42–47.
8.
Wilton P: KIGS, the Kabi International Growth Study: Adverse events report No 6. Kabi International Growth Study 1995;report 12:41–49.
9.
Tanner JM, Whitehouse RH, Takaishi M: Standards form birth to maturity for height, weight, height velocity and weight velocity: British children, 1965. Arch Dis Child 1966;41:454–471 and 613–635.
10.
Tanner JM: Fetus into Man. London, Open Books, 1978.
11.
Freeman JV, Cole TJ, Chinn S, Jones PRM, White EM, Preece MA: Cross-sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 1995;73:17–24.
12.
Greulich W, Pyle S: Radiographic atlas of skeletal development of the hand and wrist, ed 2. Stanford, Stanford University Press, 1959.
13.
Tanner J, Whitehouse R, Marshall W, Healy M, Goldstein H: Assessment of skeletal maturity and prediction of adult height (TW2 method). London, Academic Press, 1975.
14.
Ranke MB, Guilbaud O, Lindberg A, Cole T: Prediction of the growth response in children with various growth disorders treated with growth hormone: Analyses of data from the Kabi Pharmacia International Growth Study. Acta Paediatr Suppl 1993;391:82–88.
15.
Graves DA: Utility of the National Cooperative Growth Study database for safety reporting. J Pediatr Suppl 1996;128:S1–S3.
16.
Price DA: Characteristics and first year response to growth hormone of children with craniopharyngioma. Kabi International Growth Study 1990;report 5:25–38.
17.
Lyen KR, Grant DB: Endocrine function, morbidity, and mortality after surgery for craniopharyngioma. Arch Dis Child 1982;57:837–841.
18.
Sorva R, Heiskamen O: Craniopharyngioma in Finland. A study of 123 cases. Acta Neurochir (Wien) 1986;81:85–89.
19.
Price DA, Ranke MB, Albertsson-Wikland K, Maes M, Wilton P: Stopping GH treatment in IGHD. Are there good reasons (abstract)? 35th Annual ESPE Meeting. Hormone Res 1996;46(suppl 2):42.
20.
Ranke MB, Jönnson P: Who stops growth hormone in KIGS, the Kabi International Growth Study – and why? Kabi International Growth Study 1995;report 12:33–39.
21.
Beshyah SA, Henderson A, Niththyananthan R, Skinner E, Anyaoku V, Richmond W, Sharp P, Johnston DG: The effects of short and long term growth hormone replacement therapy in hypopituitary adults on lipid metabolism and carbohydrate tolerance. J Clin Endocrinol Metab 1995;80:356–363.
22.
Beshyah SA, Kyd P, Thomas E, Fairney A, Johnston DG: The effects of prolonged growth hormone replacement on bone metabolism and bone mineral density in hypopituitary adult. Clin Endocrinol 1995;42:249–254.
23.
Hew FL, Alford FP, Christopher M, Rantzau C, Koschmann M, Neal D, Ward G, Best JD, Clemmons DR, Sonksen PH: Effects of growth hormone deficiency and therapy in adults on skeletal muscle glucose metabolism, lipid profiles and regional body composition. Endocrinol Metab 1996;3:55–60.
24.
Johannsson G, Rosen T, Lindstedt G, Bosaeus I, Bengtsson BA: Effect of 2 years of growth hormone treatment on body composition and cardiovascular risk factors in adults with growth hormone deficiency. Endocrinol Metab 1996;3:3–12.
25.
Russell-Jones DL, Watts GF, Weissberger A, Naoumova R, Myers J, Thompson GR, Sonksen PH: The effect of growth-hormone replacement on serum-lipids, lipoproteins, apolipoproteins and cholesterol precursors in adult growth-hormone deficient patients. Clin Endocrinol 1994;41:345–350.
26.
Schoenle EJ, Zapf J, Prader A, Torresani T, Werder EA, Zachmann M: Replacement of growth hormone (GH) in normally growing GH-deficient patients operated for craniopharyngioma. J Clin Endocrinol Metab 1995;80:374–378.
27.
Price DA, Ranke MB: Final height following growth hormone treatment; in Ranke MB, Gunnarsson R (eds): Progress in Growth Hormone Therapy – 5 Years of KIGS. Mannheim, J-und-J, 1994:129–144.
28.
Moshang T, Rundle AC, Graves DA, Nickas J, Johanson A, Meadows A: Brain tumor recurrence in children treated with growth hormone: The National Cooperative Growth Study experience. J Pediatr Suppl 1996;128:S4–S7.
29.
Cowell CT, Dietsch S: Adverse events during growth hormone therapy. J Pediatr Endocrinol Metab 1995;8:243–252.
30.
Wilton P: KIGS, the Kabi International Growth Study: Adverse events report No 5. Kabi International Growth Study 1994;report 11:47–57.
1998
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