TY - JOUR
T1 - Prevalence and risk factors of radiation-induced growth hormone deficiency in childhood cancer survivors: A systematic review
AU - Mulder, Renée L.
AU - Kremer, Leontien C. M.
AU - van Santen, Hanneke M.
AU - Ket, Jan Lucas
AU - van Trotsenburg, A. S. Paul
AU - Koning, Caro C. E.
AU - Schouten-van Meeteren, Antoinette Y. N.
AU - Caron, Huib N.
AU - Neggers, Sebastian J. C. M. M.
AU - van Dalen, Elvira C.
PY - 2009
Y1 - 2009
N2 - Background: Growth hormone deficiency (GHD) is usually the first and most frequent endocrine problem occurring after cranial radiotherapy (CRT). The aim of this systematic review was to evaluate the existing evidence of the prevalence and risk factors of radiation-induced GHD in childhood cancer survivors. Methods: MEDLINE, EMBASE and CENTRAL were searched for studies reporting on radiation-induced GHD in childhood cancer survivors. Information about study characteristics, prevalence and risk factors was abstracted and the quality of each study was assessed. A meta-regression analysis was performed. Results: The prevalence of radiation-induced GHD was estimated in 33 studies. Most studies had methodological limitations. The prevalence varied considerably between 0% and 90.9%. Selecting only the studies with adequate peak GH cut-off limits ( <5 mu g/L) resulted in 3 studies. In these studies the prevalence ranged from 29.0% to 39.1%, with a pooled prevalence of 35.6%. Higher CRT dose and longer follow-up time have been suggested to be the main risk factors of GHD by studies included in this review. The meta-regression analysis showed that the wide variation in the prevalence of GHD could be explained by differences in maximal CRT dose. Conclusions: GHD is a frequent consequence after CRT in childhood cancer survivors. The prevalence of radiation-induced GHD ranged from 29.0% to 39.1% when selecting only studies with adequate peak GH cut-off limits. Higher CRT dose and longer follow-up time are the main risk factors. More well-designed studies are needed to accurately estimate the prevalence of GHD and to define the exact CRT threshold dose. (C) 2009 Elsevier Ltd. All rights reserved
AB - Background: Growth hormone deficiency (GHD) is usually the first and most frequent endocrine problem occurring after cranial radiotherapy (CRT). The aim of this systematic review was to evaluate the existing evidence of the prevalence and risk factors of radiation-induced GHD in childhood cancer survivors. Methods: MEDLINE, EMBASE and CENTRAL were searched for studies reporting on radiation-induced GHD in childhood cancer survivors. Information about study characteristics, prevalence and risk factors was abstracted and the quality of each study was assessed. A meta-regression analysis was performed. Results: The prevalence of radiation-induced GHD was estimated in 33 studies. Most studies had methodological limitations. The prevalence varied considerably between 0% and 90.9%. Selecting only the studies with adequate peak GH cut-off limits ( <5 mu g/L) resulted in 3 studies. In these studies the prevalence ranged from 29.0% to 39.1%, with a pooled prevalence of 35.6%. Higher CRT dose and longer follow-up time have been suggested to be the main risk factors of GHD by studies included in this review. The meta-regression analysis showed that the wide variation in the prevalence of GHD could be explained by differences in maximal CRT dose. Conclusions: GHD is a frequent consequence after CRT in childhood cancer survivors. The prevalence of radiation-induced GHD ranged from 29.0% to 39.1% when selecting only studies with adequate peak GH cut-off limits. Higher CRT dose and longer follow-up time are the main risk factors. More well-designed studies are needed to accurately estimate the prevalence of GHD and to define the exact CRT threshold dose. (C) 2009 Elsevier Ltd. All rights reserved
U2 - https://doi.org/10.1016/j.ctrv.2009.06.004
DO - https://doi.org/10.1016/j.ctrv.2009.06.004
M3 - Review article
C2 - 19640651
SN - 0305-7372
VL - 35
SP - 616
EP - 632
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
IS - 7
ER -