Original Article
Endocrinological outcome in children and adolescents survivors of central nervous system tumours after a 5 year follow-up
Secuelas endocrinológicas en niños y adolescentes supervivientes de tumores del sistema nervioso central tras 5 años de seguimiento
M. Güemes Hidalgoa, M.T. Muñoz Calvoa,b,c,d,
, L. Fuente Blancoa, C. Villalba Castañoa, G.A. Martos Morenoa,b,c,d, J. Argentea,b,c,d,
Corresponding author
Corresponding author
a Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
b Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
c Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, Spain
d Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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"apellidos" => "Argente" "email" => array:1 [ 0 => "jesus.argente@uam.es" ] "referencia" => array:5 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Secuelas endocrinológicas en niños y adolescentes supervivientes de tumores del sistema nervioso central tras 5 años de seguimiento" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-06-25" "fechaAceptado" => "2013-06-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec330028" "palabras" => array:4 [ 0 => "Childhood brain tumours" 1 => "Endocrine late effects" 2 => "Hypothalamic pituitary axis" 3 => "Cancer survivors" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec330027" "palabras" => array:4 [ 0 => "Tumores cerebrales infantiles" 1 => "Secuelas endocrinas" 2 => "Eje hipotálamo-hipofisario" 3 => "Supervivientes de cáncer" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Given the successful increase in survival rates with the current treatments for central nervous system tumours (CNST), survivors are at high risk for late adverse effects.</p> <span class="elsevierStyleSectionTitle" id="sect0015">Purpose</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To evaluate the endocrine sequelae in children with CNST according to the type of tumour and treatment received.</p> <span class="elsevierStyleSectionTitle" id="sect0020">Patients and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A retrospective review of the clinical features, auxology, hormone determinations and imaging findings of 38 patients (36.8% females, 63.2% males) with CNST, with a minimum of 5 years follow-up, was performed.</p> <span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The mean age at diagnosis was 5.34±3.07 years, with 76.3% of the patients having at least one hormone deficiency, of which growth hormone (GH) (73.7% of all patients) was the most prevalent, followed by thyrotropin (TSH) (68.4%), corticotropin (31.6%), antidiuretic hormone (28.9%), and gonadotropin (LH/FSH) (21.1%) deficiency. Precocious puberty was found in 21.1% of patients. After 5 years of follow-up, 28.9% were obese. Craniopharyngioma had more hormone deficiency, obesity and recurrence rates. The most frequently administered treatment was surgery + chemotherapy + radiotherapy, in 47.4% of the patients. Mean fi height (20 patients) was -1.2 1.6 SDS, with a mean difference of -0.53 SDS regarding their target height.</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">1) The type of tumour and treatment received influence the endocrinological sequelae. 2) The most frequent hormone deficiencies in all types of CNST, regardless of the treatment received, were GH and TSH. 3) Early diagnosis and prompt intervention of endocrine dysfunction can reduce the morbidity and improve quality of life over the long term.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Con las terapias actuales, la supervivencia de los tumores del sistema nervioso central (TSNC) es cada vez mayor y, con ello, las complicaciones a largo plazo.</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Evaluar las secuelas endocrinológicas en niños con TSNC en relación con el tipo de neoplasia y el tratamiento recibido.</p> <span class="elsevierStyleSectionTitle" id="sect0050">Sujetos y métodos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se revisaron retrospectivamente los datos clínicos, auxológicos, analíticos y radiológicos de 38 pacientes (36,8% mujeres y 63,2% varones) con antecedente de TSNC y seguimiento mínimo de 5 años.</p> <span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La media ± desviación estándar de edad al diagnóstico fue de 5,34 ± 3,07 años. El 76,3% de los casos presentó al menos un déficit hormonal, siendo el más prevalente el de hormona de crecimiento (GH) (73,7%), seguido de los déficits de tirotropina (TSH) (68,4%), corticotropina (31,6%), hormona antidiurética (28,9%) y gonadotropinas (LH/FSH) (21,1%). El 21,1% de los pacientes presentaron pubertad precoz. A los 5 años de seguimiento, el 28,9% presentaba obesidad. El craneofaringioma fue el tipo tumoral que registró mayor número de casos con deficiencias hormonales, obesidad y tasa de recurrencia. El tratamiento más frecuentemente administrado fue la combinación de cirugía + quimioterapia + radioterapia, empleado en el 47,4% de los pacientes. La talla final media ± desviación estándar (20 pacientes) fue −1,2 ± 1,6; con una disminución media de −0,53 DE respecto de su talla diana.</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">1) El tipo tumoral y el tratamiento recibido influyen sobre las secuelas endocrinológicas; 2) las deficiencias hormonales más frecuentes en todos los tipos de TSNC, independientemente del tratamiento recibido, fueron GH y TSH; 3) el diagnóstico precoz y la intervención temprana sobre la disfunción endocrina, reducen la morbilidad y mejoran la calidad de vida a largo plazo.</p>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Previous presentation of the work: certain aspects of this research were presented as a poster at the 51st Annual Meeting of the European Society of Paediatric Endocrinology (ESPE), held in Leipzig (Germany) held 20-23 September 2012. The authors and title of this communication were: Güemes M, Fuente L, Caballero FJ, Martos-Moreno G, Muñoz-Calvo MT, Argente J. Endocrinological effects in survivors of central nervous system tumours after a 5 year follow-up”.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Güemes Hidalgo M, Muñoz Calvo MT, Fuente Blanco L, Villalba Castaño C. Martos Moreno GA, Argente J. Secuelas endocrinológicas en niños y adolescentes supervivientes de tumores del sistema nervioso central tras 5 años de seguimiento. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 13 | 19 |
| 2024 October | 43 | 40 | 83 |
| 2024 September | 40 | 56 | 96 |
| 2024 August | 58 | 90 | 148 |
| 2024 July | 39 | 50 | 89 |
| 2024 June | 36 | 32 | 68 |
| 2024 May | 45 | 33 | 78 |
| 2024 April | 30 | 36 | 66 |
| 2024 March | 36 | 26 | 62 |
| 2024 February | 40 | 34 | 74 |
| 2024 January | 22 | 22 | 44 |
| 2023 December | 25 | 24 | 49 |
| 2023 November | 27 | 22 | 49 |
| 2023 October | 27 | 28 | 55 |
| 2023 September | 17 | 21 | 38 |
| 2023 August | 26 | 16 | 42 |
| 2023 July | 38 | 30 | 68 |
| 2023 June | 30 | 29 | 59 |
| 2023 May | 41 | 18 | 59 |
| 2023 April | 20 | 22 | 42 |
| 2023 March | 34 | 25 | 59 |
| 2023 February | 19 | 18 | 37 |
| 2023 January | 14 | 20 | 34 |
| 2022 December | 32 | 24 | 56 |
| 2022 November | 46 | 25 | 71 |
| 2022 October | 32 | 45 | 77 |
| 2022 September | 45 | 32 | 77 |
| 2022 August | 53 | 54 | 107 |
| 2022 July | 45 | 37 | 82 |
| 2022 June | 36 | 46 | 82 |
| 2022 May | 20 | 33 | 53 |
| 2022 April | 25 | 38 | 63 |
| 2022 March | 35 | 46 | 81 |
| 2022 February | 16 | 32 | 48 |
| 2022 January | 29 | 39 | 68 |
| 2021 December | 29 | 58 | 87 |
| 2021 November | 26 | 58 | 84 |
| 2021 October | 43 | 67 | 110 |
| 2021 September | 21 | 52 | 73 |
| 2021 August | 22 | 34 | 56 |
| 2021 July | 17 | 43 | 60 |
| 2021 June | 27 | 32 | 59 |
| 2021 May | 25 | 24 | 49 |
| 2021 April | 66 | 64 | 130 |
| 2021 March | 38 | 27 | 65 |
| 2021 February | 18 | 16 | 34 |
| 2021 January | 31 | 18 | 49 |
| 2020 December | 29 | 26 | 55 |
| 2020 November | 23 | 17 | 40 |
| 2020 October | 20 | 22 | 42 |
| 2020 September | 11 | 16 | 27 |
| 2020 August | 8 | 8 | 16 |
| 2020 July | 21 | 13 | 34 |
| 2020 June | 27 | 19 | 46 |
| 2020 May | 33 | 17 | 50 |
| 2020 April | 19 | 15 | 34 |
| 2020 March | 20 | 11 | 31 |
| 2020 February | 39 | 16 | 55 |
| 2020 January | 26 | 17 | 43 |
| 2019 December | 23 | 23 | 46 |
| 2019 November | 18 | 14 | 32 |
| 2019 October | 20 | 14 | 34 |
| 2019 September | 18 | 20 | 38 |
| 2019 August | 25 | 16 | 41 |
| 2019 July | 15 | 28 | 43 |
| 2019 June | 17 | 34 | 51 |
| 2019 May | 36 | 26 | 62 |
| 2019 April | 78 | 27 | 105 |
| 2019 March | 30 | 12 | 42 |
| 2019 February | 29 | 30 | 59 |
| 2019 January | 27 | 30 | 57 |
| 2018 December | 35 | 34 | 69 |
| 2018 November | 48 | 34 | 82 |
| 2018 October | 50 | 24 | 74 |
| 2018 September | 40 | 20 | 60 |
| 2018 August | 1 | 0 | 1 |
| 2018 July | 1 | 0 | 1 |
| 2018 June | 1 | 0 | 1 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 15 | 0 | 15 |
| 2018 March | 10 | 0 | 10 |
| 2018 February | 4 | 0 | 4 |
| 2018 January | 11 | 0 | 11 |
| 2017 December | 8 | 0 | 8 |
| 2017 November | 19 | 0 | 19 |
| 2017 October | 19 | 0 | 19 |
| 2017 September | 14 | 0 | 14 |
| 2017 August | 9 | 0 | 9 |
| 2017 July | 15 | 1 | 16 |
| 2017 June | 13 | 19 | 32 |
| 2017 May | 23 | 11 | 34 |
| 2017 April | 18 | 2 | 20 |
| 2017 March | 17 | 12 | 29 |
| 2017 February | 14 | 2 | 16 |
| 2017 January | 8 | 6 | 14 |
| 2016 December | 16 | 9 | 25 |
| 2016 November | 33 | 6 | 39 |
| 2016 October | 44 | 8 | 52 |
| 2016 September | 33 | 12 | 45 |
| 2016 August | 21 | 1 | 22 |
| 2016 July | 11 | 2 | 13 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 1 | 14 | 15 |
| 2015 October | 2 | 15 | 17 |
| 2015 September | 1 | 0 | 1 |
| 2015 January | 1 | 0 | 1 |
| 2014 December | 2 | 1 | 3 |
| 2014 November | 3 | 0 | 3 |
| 2014 October | 3 | 0 | 3 |
| 2014 September | 2 | 0 | 2 |
| 2014 August | 1 | 0 | 1 |
| 2014 July | 4 | 0 | 4 |
| 2014 June | 15 | 2 | 17 |
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