Prevalence and Risk Factors of Early Endocrine Disorders in Childhood Brain Tumor Survivors: A Nationwide, Multicenter Study

Purpose To evaluate the prevalence of, and risk factors for, early endocrine disorders in childhood brain tumor survivors (CBTS). Patients and Methods This nationwide study cohort consisted of 718 CBTS who were diagnosed between 2002 and 2012, and who survived ≥ 2 years after diagnosis. Patients with craniopharyngeoma or a pituitary gland tumor were excluded. Results of all endocrine investigations, which were performed at diagnosis and during follow-up, were collected from patient charts. Multivariable logistic regression was used to study associations between demographic and tumor- and treatment-related variables and the prevalence of early endocrine disorders. Results After a median follow-up of 6.6 years, 178 CBTS (24.8%) were diagnosed with an endocrine disorder. A total of 159 CBTS (22.1%) presented with at least one endocrine disorder within the first 5 years after diagnosis. The most common endocrine disorders were growth hormone deficiency (12.5%), precocious puberty (12.2%), thyroid-stimulating hormone deficiency (9.2%), and thyroidal hypothyroidism (5.8%). The risk of hypothalamic-pituitary dysfunction (n = 138) was associated with radiotherapy (odds ratio [OR], 15.74; 95% CI, 8.72 to 28.42), younger age at diagnosis (OR, 1.09; 95% CI, 1.04 to 1.14), advanced follow-up time (OR, 1.10; 95% CI, 1.02 to 1.18), hydrocephalus at diagnosis (OR, 1.77; 95% CI, 1.09 to 2.88), and suprasellar (OR, 34.18; 95% CI, 14.74 to 79.29) and infratentorial (OR, 2.65; 95% CI, 1.48 to 4.74) tumor site. Conclusion The prevalence of early endocrine disorders among CBTS is high. The observation that 22.1% of CBTS developed at least one endocrine disorder within the first 5 years after diagnosis stresses the importance of early and regular assessment of endocrine function in CBTS who are at risk for endocrine damage.

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Prevalence of endocrine disorders in childhood brain tumor survivors in South Korea: A nationwide population-based, longitudinal study.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e21517 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e21517-e21517

Author(s):

Jaesung Heo ◽

O Kyu Noh ◽

Jun Eun Park ◽

Minhyung Cho ◽

Seonghye Choi

Keyword(s):

Brain Tumor ◽

Longitudinal Study ◽

South Korea ◽

Odds Ratio ◽

Treatment Compliance ◽

Endocrine Function ◽

Hormone Deficiency ◽

Endocrine Disorders ◽

Childhood Brain Tumor

e21517 Background: Brain tumors are the most common solid cancers in child patients with a current expected 5-year overall survival rate of 73%. Also, patients with brain cancer tend to have a high rate of neuroendocrine disorders. These endocrine problems may have a significant negative effect on quality of life and treatment compliance. Methods: The aim of this longitudinal study was to analyze the prevalence of endocrine disorders in childhood brain tumor survivors using claims data in South Korea. We confirmed endocrine disorders in a nationwide cohort of 1,058 patients who were diagnosed with brain tumor between January 1, 2009 and March 29, 2016 and who survived > 2 years after diagnosis. Multivariable logistic regression was used to evaluate association between demographic and treatment related variables and the prevalence of endocrine disorders. Results: After a median follow-up of 60.0 months, a total of 393 (37.1%) patients were diagnosed with at least one endocrine disorder. The median follow-up time from primary brain tumor diagnosis to diagnosis of first endocrine disorders was 26.3 months (range, 0.06 to 96.7). Of those patients, 333 childhood brain tumor survivors were diagnosed with endocrine disorders during their first 5 years after diagnosis. The overall frequency of endocrine disorders peaked during 2 months after the cancer diagnosis. The most common endocrine disorders were pituitary dysfunction (21.9%), thyroidal disease (6.1%), precocious puberty (4.6%), and growth hormone deficiency (4.3%). Female patients were at a higher risk for endocrine disorders (odds ratio: 1.45, p = 0.005). The patients with radiotherapy were more likely to have endocrine disorders compared without radiotherapy (odds ratio: 1.79, p < 0.001). Conclusions: Endocrine disorders in childhood brain tumor survivors was high and showed different patterns of prevalence depending on the nature of disease and time sequence. In childhood brain tumor survivors who are risk of endocrine disorders, regular assessment of endocrine function and timely intervention were needed. [Table: see text]

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High Prevalence of Weight Gain in Childhood Brain Tumor Survivors and Its Association With Hypothalamic-Pituitary Dysfunction

Journal of Clinical Oncology ◽

10.1200/jco.20.01765 ◽

2021 ◽

pp. JCO.20.01765

Author(s):

Jiska van Schaik ◽

Ichelle M. A. A. van Roessel ◽

Netteke A. Y. N. Schouten-van Meeteren ◽

Laura van Iersel ◽

Sarah C. Clement ◽

...

Keyword(s):

Risk Factors ◽

Brain Tumor ◽

Weight Gain ◽

Standard Deviation Score ◽

Cardiometabolic Health ◽

Low Grade ◽

Childhood Brain Tumor ◽

Significant Weight Gain ◽

Overweight Or Obesity

PURPOSE Childhood brain tumor survivors (CBTS) are at risk for developing obesity, which negatively influences cardiometabolic health. The prevalence of obesity in CBTS may have been overestimated in previous cohorts because of inclusion of children with craniopharyngioma. On the contrary, the degree of weight gain may have been underestimated because of exclusion of CBTS who experienced weight gain, but were neither overweight nor obese. Weight gain may be an indicator of underlying hypothalamic-pituitary (HP) dysfunction. We aimed to study prevalence of and risk factors for significant weight gain, overweight, or obesity, and its association with HP dysfunction in a national cohort of noncraniopharyngioma and nonpituitary CBTS. METHODS Prevalence of and risk factors for significant weight gain (body mass index [BMI] change ≥ +2.0 standard deviation score [SDS]), overweight, or obesity at follow-up, and its association with HP dysfunction were studied in a nationwide cohort of CBTS, diagnosed in a 10-year period (2002-2012), excluding all craniopharyngioma and pituitary tumors. RESULTS Of 661 CBTS, with a median age at follow-up of 7.3 years, 33.1% had significant weight gain, overweight, or obesity. Of the CBTS between 4 and 20 years of age, 28.7% were overweight or obese, compared with 13.2% of the general population between 4 and 20 years of age. BMI SDS at diagnosis, diagnosis of low-grade glioma, diabetes insipidus, and central precocious puberty were associated with weight gain, overweight, or obesity. The prevalence of HP dysfunction was higher in overweight and obese CTBS compared with normal-weight CBTS. CONCLUSION Overweight, obesity, and significant weight gain are prevalent in CBTS. An increase in BMI during follow-up may be a reflection of HP dysfunction, necessitating more intense endocrine surveillance.

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Prevalence and Risk Factors of Hypothalamic-Pituitary Dysfunction in Infant and Toddler Childhood Brain Tumor Survivors

Acta Endocrinologica ◽

10.1530/eje-21-0137 ◽

2021 ◽

Author(s):

C A Lebbink ◽

T.p Ringers ◽

A.y.n. Schouten-van Meeteren ◽

L van Iersel ◽

S.c Clement ◽

...

Keyword(s):

Risk Factors ◽

Brain Tumor ◽

Age Groups ◽

Tumor Location ◽

Childhood Brain Tumor ◽

Older Children ◽

Treatment Protocols ◽

Pituitary Dysfunction ◽

Frequent Use

Objective Childhood brain tumor survivors (CBTS) are at risk to develop hypothalamic-pituitary (HP) dysfunction (HPD). The risk for HPD may vary between different age groups due to maturation of the brain and differences in oncologic treatment protocols. Specific studies on HPD in infant brain tumor survivors (infant-BTS, 0-1 years at diagnosis) or toddler brain tumor survivors (toddler-BTS, ≥1-3 years) have not been performed. Patients and Methods A retrospective nationwide cohort study in CBTS was performed. Prevalence and risk factors for HPD were compared between infant-, toddler- and older-BTS. Subgroup analysis was performed for all non-irradiated CBTS (n=460). Results In total 718 CBTS were included, with a median follow-up time of 7.9 years. Overall, despite less frequent use of radiotherapy (RT) in infants, no differences in prevalence of HPD were found between the three groups. RT (OR 16.44; 95%CI 8.93 to 30.27), suprasellar tumor location (OR 44.76; 95%CI 19.00 to 105.49) and younger age (OR 1.11; 95%CI 1.05 to 1.18) were associated with HP dysfunction. Infant-BTS and toddler-BTS showed more weight gain (p<0.0001) and smaller height SDS (p=0.001) during follow-up. In non-irradiated CBTS, infant-BTS and toddler-BTS were significantly more frequently diagnosed with TSH-, ACTH- and ADH deficiency, compared to older-BTS. Conclusion Infant and toddler brain tumor survivors seem to be more vulnerable to develop HP dysfunction than older children. These results emphasize the importance of special infant- and toddler brain tumor treatment protocols and the need for endocrine surveillance in children treated for a brain tumor at young age.

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Prevalence and Risk Factors of Hypothalamic-Pituitary Dysfunction in Infant and Toddler Brain Tumor Survivors

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1463 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A719-A719

Author(s):

Chantal A Lebbink ◽

Tiara P Ringers ◽

Antoinette Y N Schouten-van Meeteren ◽

Laura van Iersel ◽

Sarah C Clement ◽

...

Keyword(s):

Risk Factors ◽

Brain Tumor ◽

Age Groups ◽

Tumor Location ◽

Childhood Brain Tumor ◽

Older Children ◽

Treatment Protocols ◽

Pituitary Dysfunction ◽

Oncologic Treatment

Abstract Background: Childhood brain tumor survivors (CBTS) are at risk for hypothalamic-pituitary (HP) dysfunction, mainly caused by radiation exposure or tumor involvement of the HP-region. The risk for HP dysfunction (HPD) may vary between different age groups due to maturation of the brain and differences in oncologic treatment protocols. The aim of this study was to determine the prevalence and risk factors of HPD in infant (IBTS) and toddler brain tumor survivors (TBTS) compared to older childhood brain tumor survivors (OCBTS). Patients and Methods: A retrospective analysis in a nationwide cohort of CBTS was performed. Prevalence and risk factors for HPD were compared between IBTS (aged 0-1 years at diagnosis), TBTS (aged 1-3 years at diagnosis) and OCBTS (aged >3-18 years at diagnosis). Results: In 718 included CBTS, with a median follow-up time of 7.9 years, overall no differences in percentage of HPD were found between the three age groups. Treatment with radiotherapy (RT) (OR 15.41; 95%CI 8.33 to 28.48), suprasellar tumor location (OR 46.62; 95%CI 19.64 to 110.66) and younger age (OR 1.09; 95%CI 1.02 to 1.15) were associated with HP dysfunction. Because IBTS were significantly less often treated with RT, subanalyses were performed for all CBTS not treated with radiation (n=459). In non-irradiated CBTS, IBTS and TBTS were significantly more frequently diagnosed with TSH-, ACTH- and ADH deficiency, compared to ECBTS. IBTS and TBTS showed significantly more weight gain (p<0.0001) and smaller height SDS (p=0.001) during follow-up. Conclusion: Infant and toddler brain tumor survivors seem to be more vulnerable to develop HP dysfunction than when compared to older children. These results emphasize the importance of special infant and toddlers brain tumor treatment protocols and endocrine surveillance in children treated for a brain tumor at young age.

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QOS-48PREVALENCE AND RISK FACTORS OF EARLY ENDOCRINE DISORDERS IN CHILDHOOD BRAIN TUMOR SURVIVORS: A NATIONWIDE MULTICENTER STUDY

Neuro-Oncology ◽

10.1093/neuonc/now081.48 ◽

2016 ◽

Vol 18 (suppl 3) ◽

pp. iii155.5-iii156

Author(s):

Sarah Clement ◽

Antoinette Schouten-van Meeteren ◽

Annemieke Boot ◽

Hedy Claahsen-vd Grinten ◽

Bernd Granzen ◽

...

Keyword(s):

Risk Factors ◽

Brain Tumor ◽

Multicenter Study ◽

Endocrine Disorders ◽

Childhood Brain Tumor

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Epidemiology of Heart Failure Stages in Middle‐Aged Black People in the Community: Prevalence and Prognosis in the Atherosclerosis Risk in Communities Study

Journal of the American Heart Association ◽

10.1161/jaha.120.016524 ◽

2021 ◽

Author(s):

Ramachandran S. Vasan ◽

Solomon K. Musani ◽

Kunihiro Matsushita ◽

Walter Beard ◽

Olushola B. Obafemi ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Heart Failure ◽

Cardiovascular Disease ◽

Left Ventricular ◽

Study Cohort ◽

Atherosclerosis Risk In Communities ◽

Cardiovascular Morbidity And Mortality ◽

Atherosclerosis Risk

Background Black individuals have a higher burden of risk factors for heart failure (HF) and subclinical left ventricular remodeling. Methods and Results We evaluated 1871 Black participants in the Atherosclerosis Risk in Communities Study cohort who attended a routine examination (1993–1996, median age 58 years) when they underwent echocardiography. We estimated the prevalences of 4 HF stages: (1) Stage 0 : no risk factors; (2) Stage A : presence of HF risk factors (hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, coronary artery disease without clinical myocardial infarction), no cardiac structural/functional abnormality; (3) Stage B : presence of prior myocardial infarction, systolic dysfunction, left ventricular hypertrophy, regional wall motion abnormality, or left ventricular enlargement; and (4) Stage C/D : prevalent HF. We assessed the incidence of clinical HF, atherosclerotic cardiovascular disease events, and all‐cause mortality on follow‐up according to HF stage. The prevalence of HF Stages 0, A, B, and C/D were 3.8%, 20.6%, 67.0%, and 8.6%, respectively, at baseline. On follow‐up (median 19.0 years), 309 participants developed overt HF, 390 incurred new‐onset cardiovascular disease events, and 651 individuals died. Incidence rates per 1000 person‐years for overt HF, cardiovascular disease events, and death, respectively, were Stage 0, 2.4, 0.8, and 7.6; Stage A, 7.4, 9.7, and 13.5; Stage B 13.6, 15.9, and 22.0. Stage B HF was associated with a 1.5‐ to 2‐fold increased adjusted risk of HF, cardiovascular disease events and death compared with Stages 0/A. Conclusions In our large community‐based sample of Black individuals, we observed a strikingly high prevalence of Stage B HF in middle age that was a marker of high cardiovascular morbidity and mortality.

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Respiratory morbidity of preterm infants of less than 33 weeks gestation without bronchopulmonary dysplasia: a 12-month follow-up of the CASTOR study cohort

Epidemiology and Infection ◽

10.1017/s0950268813001738 ◽

2013 ◽

Vol 142 (7) ◽

pp. 1362-1374 ◽

Cited By ~ 17

Author(s):

B. FAUROUX ◽

J.-B. GOUYON ◽

J.-C. ROZE ◽

C. GUILLERMET-FROMENTIN ◽

I. GLORIEUX ◽

...

Keyword(s):

Risk Factors ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Respiratory Morbidity ◽

Study Cohort ◽

Recurrent Wheezing ◽

Term Infants ◽

Independent Risk Factors ◽

Syncytial Virus

SUMMARYThe aim of this study was to describe the incidence and risk factors for respiratory morbidity during the 12-month period following the first respiratory syncytial virus (RSV) season in 242 preterm infants [<33 weeks gestational age (GA)] without bronchopulmonary dysplasia and 201 full-term infants (39–41 weeks GA) from the French CASTOR study cohort. Preterm infants had increased respiratory morbidity during the follow-up period compared to full-terms; they were more likely to have wheezing (21% vs. 11%, P = 0·007) and recurrent wheezing episodes (4% vs. 1%, P = 0·049). The 17 infants (14 preterms, three full-terms) who had been hospitalized for RSV-confirmed bronchiolitis during their first RSV season had significantly more wheezing episodes during the follow-up period than subjects who had not been hospitalized for RSV-confirmed bronchiolitis (odds ratio 4·72, 95% confidence interval 1·71–13·08, P = 0·003). Male gender, birth weight <3330 g and hospitalization for RSV bronchiolitis during the infant's first RSV season were independent risk factors for the development of wheezing episodes during the subsequent 12-month follow-up period.

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NCI Fanconi’s Anemia Cohort: Hematology and Beyond.

Blood ◽

10.1182/blood.v106.11.1057.1057 ◽

2005 ◽

Vol 106 (11) ◽

pp. 1057-1057

Author(s):

Neelam Giri ◽

Dalia Batista ◽

Constantine Stratakis ◽

Ekaterini T. Tsilou ◽

Hung J. Kim ◽

...

Keyword(s):

Brain Tumor ◽

Aplastic Anemia ◽

Head And Neck ◽

Chromosome Breakage ◽

Adverse Outcomes ◽

Hormone Deficiency ◽

Fanconi's Anemia ◽

Clinical Center ◽

Fanconi’S Anemia

Abstract Fanconi’s anemia (FA) is an inherited DNA repair disorder with very high risks of aplastic anemia (AA), myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), and squamous cell carcinomas (SCC). Patients with FA often have physical anomalies, and may develop endocrinopathies; these phenotypic features may be associated with adverse outcomes. While most of these abnormalities have been previously-reported, only prospective follow-up of a meticulously-characterized cohort can accurately quantify the prevalence and natural history of each, and determine whether specific abnormalities are strongly predictive of adverse outcomes; such information will be invaluable for evidence-based management of FA patients. To begin our formal investigation of these associations, we reviewed the medical records of 42 study participants with FA, and began prospective evaluation of a subset of 20 patients who underwent multidisciplinary evaluation at the NIH Clinical Center (FA Clinical Center Cohort - CC). The remaining 22 patients were in the FA Field Cohort (FC). We studied 17 males and 25 females. The CC and FC subjects were similar except that the former were older at the time of study (median 21.5 vs 14.3 yrs in the FC, p=0.01) and had later onset of aplastic anemia (11.8 vs 7.2 yrs, p=0.03). 36/42 (86%) had at least one FA-related congenital anomaly. 11 patients were FANCA, 9 FANCC, and 1 each FANCD1/BRCA2, FANCF, and FANCJ. 34/42 (81%) had aplastic anemia; 10 had mild to moderate and 24 had severe AA. 13/33 (38 %) had clonal cytogenetic bone marrow abnormalities, some for >3 years. 8/42 (19%) developed MDS, one of whom evolved to AML. 12 (29%) underwent BMT, 9 of whom are alive (median 4 yrs, range 9 mo-21 yrs). 3 patients were hematopoietic somatic mosaics, in whom the diagnosis of FA was confirmed by detection of chromosome breakage in skin fibroblasts; all 3 had mutations in FANCA. 23/36 (64%) had hearing loss, 4 of whom had surgery for middle ear bony abnormalities. 28/32 had microcornea, 20 microophthalmia, 21 myopia, and 4 had ptosis. 32/36 (89%) had multiple café-au-lait spots and hyper/hypopigmented areas, and 2 had Sweet’s syndrome with MDS. 9/19 (47%) had leukoplakia; 1 biopsy was positive for SCC. 29/42 (69%) had one or more endocrinopathy, including short stature, hypothyroidism, growth hormone deficiency, glucose intolerance, diabetes, dyslipidemia and metabolic syndrome. 5 patients had mid-line structural anomalies of the brain, and 1 each had a lipoma and a brain tumor. 2 patients had nonalcoholic steatohepatitis, 1 had transfusional hemosiderosis and 1 had a liver adenoma. 7/8 adult females had infertility and premature ovarian failure; 5 males had hypogenitalia. 7/7 females and 2/4 males older than 18 yrs had osteopenia or osteoporosis. 9 patients had 12 prevalent cancers at a median age of 29 yrs (range 5–44), including 5 head and neck, 4 vulvar, and 1 each nasopharyngeal, skin and brain tumor. One of the head and neck SCC occurred 13 years after BMT. Prospective screening at the NIH identified recurrent head and neck SCC in 3 patients. We conclude that FA patients need to be examined frequently in comprehensive subspecialty clinics to identify and treat significant co-morbidities, including hematologic, endocrine, and neoplastic disorders. Analysis of genotype/phenotype/cancer correlations in FA will require thorough evaluations of the type outlined here, involving larger numbers of patients; accrual to, and follow-up of, our FA cohort continues.

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Endocrine disorders with craniopharyngioma in adults before and after surgery

Problems of Endocrinology ◽

10.14341/probl201662561-62 ◽

2016 ◽

Vol 62 (5) ◽

pp. 61-62 ◽

Cited By ~ 4

Author(s):

Irina S. Klochkova ◽

Lyudmila I. Astafieva ◽

Alexsander N. Konovalov ◽

Pavel L. Kalinin ◽

Maksim A. Kutin ◽

...

Keyword(s):

Endocrine Function ◽

Pituitary Stalk ◽

Hormone Deficiency ◽

Endocrine Disorders ◽

Free T4 ◽

Group 4 ◽

Before And After ◽

Group 2 ◽

Secondary Hypoadrenalism ◽

Secondary Hypogonadism

Background. Craniopharyngiomas (CF) - a benign tumor of the embryologic origin. The surgical method of treatment is basic.Aim: to estimate dynamics of endocrine disorders before and after surgical treatment of CF at different topographical variations.Methods.The research involved 42 patients older than 18 years (25 women and 17 men) with a mean age - 41 [21; 69] with a verified diagnosis of CF. All patients were operated in 28 cases – total resection, in 7 - the pituitary stalk was saved. Before and 6 months after the surgery all patients were examined by means of hormonal blood tests (TSH, free T4, cortisol, prolactin, LH , FSH, estradiol, testosterone, IGF-1). By tumor localizing patients were divided into 4 groups: 1 – intra-suprasellar (2) 2 – at location of the pituitary stalk (15), 3 – combined «the pituitary stalk» and ventricular (10), 4 –intra-ventricular (15).Results. In group 1: panhypopituitarism -2 (100%), diabetes insipidus (DI) – 0. Both patients had subtotal ablation. After the surgery the nature of disturbance has not changed. In group 2: secondary hypoadrenalism - 9 (60%), hypothyroidism - 11 (73%), hypogonadism - 12 (80%), DI - 7 (46%), hyperprolactinemia - 9 (60%). After the surgery panhypopituitarism - 15 (100%), DI - 14 (93%), hyperprolactinemia - 4 (26 %). In group 3: secondary hypoadrenalism - 3 (30%), hypothyroidism - 6 (60%), hypogonadism - 6 (60%), DI - 2 (20%), hyperprolactinemia - 3 (30%). After the surgery panhypopituitarism - 10 (100%), DI - 10 (100%), hyperprolactinemia - 3 (30 %). In group 4: secondary hypoadrenalism - 6 (40%), hypothyroidism - 9 (60%), hypogonadism - 12 (80%), DI - 5 (33%), hyperprolactinemia - 8 (53%). After the surgery panhypopituitarism - 10 (71%), secondary hypoadrenalism - 12 (85%), hypothyroidism - 13 (92%), hypogonadism - 11 (79%), DI - 11 (78%), hyperprolactinemia - 8 (53%).Conclusion. The high incidence of endocrine disorders is caused by the localization of the CF with predominance of secondary hypogonadism and hypothyroidism. After the surgery worsening hormone deficiency was mentioned, also while preserving the pituitary stalk. Non-radical ablation of ventricular CF can partially maintain endocrine function.

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Prevalence of childhood growth hormone deficiency in survivors of pediatric intracranial germ cell tumors.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e22526 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e22526-e22526

Author(s):

Diana Lone ◽

Karim Thomas Sadak ◽

Bradley S Miller ◽

Michelle Roesler ◽

Jenny N Poynter

Keyword(s):

Growth Hormone ◽

Germ Cell ◽

Growth Hormone Deficiency ◽

Late Effects ◽

Germ Cell Tumors ◽

Hormone Deficiency ◽

Endocrine Disorders ◽

Intracranial Germ Cell Tumors

e22526 Background: Survival rates for childhood cancer continue to rise, and there are now greater than 420,000 survivors in the United States. However, high cure rates come at the cost of short and long-term treatment-related toxicities. Endocrine disorders are among the most common late effects and are associated with poor health outcomes and lower quality of life. Survivors of pediatric intracranial germ cell tumors (iGCTs) are at high risk for endocrine disorders, particularly for growth hormone deficiency (GHD), due to their exposures to cranial radiation, chemotherapy, and brain surgery. To date, no long-term follow-up studies have explored the late effects experienced by survivors of iGCTs. Methods: Study participants were enrolled in the Germ Cell Tumor Epidemiology Study, which is a case-parent triad study conducted using the resources of the Children’s Oncology Group’s Childhood Cancer Research Network. Eligibility criteria included diagnosis with a germ cell tumor in any location at age 0-19 years in the years 2008-2015. The study population included 233 cases with a diagnosis of iGCT. We are currently following the cohort to evaluate outcomes and late effects of treatment, including medical record review to extract data on treatment characteristics and hormone deficiencies. This interim analysis includes chart review for 57 iGCT cases. Results: Of the 57 cases reviewed, there was a male predominance (73.7%) with the highest prevalence in non-Hispanic whites (80.4%). Cases of iGCTs can be subdivided into two main histologic subtypes, germinomas (36 cases) and non-germinomatous GCTs (NGGCT, 21 cases). The median age at diagnosis was 14.6 years for the germinomas and 10.5 years for NGGCTs. Data on growth hormone deficiency (GHD) was available for 42 of the 57 cases with a median follow-up of 7.4 years. Twenty-eight of the 42 cases (66.7%) had GHD; 19 in the germinoma group and 9 in the NGGCT group (p = 0.47). 17 of those with GHD were males (p = 0.10). There was no significant difference in prevalence of GHD by age of tumor diagnosis (p = 0.20). Conclusions: Survivors of iGCTs are at high risk for growth hormone deficiency. Identifying specific risk factors for developing GHD amongst these survivors can enhance the current guidelines for screening and management.

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