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Adverse effect of therapy and late sequelae in survivors

  • H. Shirato
  • Y. Sawamura
  • M. Tada
  • R. Brauner
  • L. Adan
  • J.-C. Souberbielle
  • N. Satoh
  • M. Kashiwamura
  • Y. Sawamura
  • M. Tada
  • Y. Sawamura
  • J.-I. Murata

Abstract

At least four factors may contribute to the diminished height achieved in adulthood by children having undergone craniospinal irradiation: i) growth hormone (GH) deficiency, ii) induction of precocious puberty [1,2,51], iii) effects on growth plate of bone [51], and possibly iv) dysfunction of testis or ovary and thyroid gland when these are irradiated (see the section on Hypothalamic-pituitary Function and Their management). Shalet et al. estimated growth reduction due to whole spinal irradiation to be 9,7 and 5.5 cm at the age of 1, 5 and 10 years, respectively [59]. If growth hormone replacement and gonadotropin releasing hormone analog therapies are successful, growth hormone can maintain the growth of legs of patients with precocious puberty. Nevertheless, these still have a short sitting height due to diminished growth of the spine after irradiation [6,30]. If the treatment for CNS GCT does not involve spinal irradiation, adult height after radiotherapy depends on GH deficiency and precocious puberty, specifically, the GH peak after irradiation and the age at which pubertal development occurs [2]. Effect of chemotherapy on adult height has been reported negligible [2], but a combination chemotherapy and craniospinal irradiation induces more growth delay than craniospinal irradiation alone [45].

Keywords

Pineal Gland Growth Hormone Deficiency Adult Height Precocious Puberty Cranial Irradiation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag/Wien 1998

Authors and Affiliations

  • H. Shirato
    • 1
  • Y. Sawamura
    • 1
  • M. Tada
    • 2
  • R. Brauner
    • 3
  • L. Adan
    • 3
  • J.-C. Souberbielle
    • 4
  • N. Satoh
    • 5
  • M. Kashiwamura
    • 5
  • Y. Sawamura
    • 5
  • M. Tada
    • 2
  • Y. Sawamura
    • 2
  • J.-I. Murata
    • 2
  1. 1.Department of Radiology and NeurosurgeryHokkaido University School of MedicineSapporoJapan
  2. 2.Department of NeurosurgeryHokkaido University School of MedicineSapporoJapan
  3. 3.Pediatric Endocrinology UnitUniversité Paris V and Hôpital Necker Enfants MaladesAssistance Publique- Hôpitaux de ParisFrance
  4. 4.Physiology LaboratoryUniversité Paris V and Hôpital Necker Enfants MaladesAssistance Publique- Hôpitaux de ParisFrance
  5. 5.Departments of Otolaryngology and NeurosurgeryHokkaido University School of MedicineSapporoJapan

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