GROWTH IMPAIRMENT AND GROWTH-HORMONE THERAPY IN CHILDREN TREATED FOR MALIGNANT BRAIN-TUMORS

Eighty-two children with malignant brain rumours were treated accordin g to the ''8 in 1'' chemotherapy protocol in Finland during 1986 to 19 93. Thirty-seven with brain tumours not involving the hypothalamic-pit uitary region are still alive and tumour-free. The growth and response to growth hormone (GH) therapy in these children was analysed. Childr en who received craniospinal irradiation had the most severe loss of h eight SDS, being -1.07 within 3 years of the diagnosis. Even children with no irradiation to the hypothalamic-pituitary axis had a mean chan ge in height SDS of -0.5 after 3 years. Fifteen of 23 children who rec eived craniospinal irradiation and two out of eight children who recei ved cranial irradiation have received GH therapy. A catch-up growth re sponse to the daily GH therapy with the mean dose of 0.7 IU/kg per wee k was complete in 3 years (+ 1.87 SDS), irrespective of craniospinal i rradiation, in children who were treated at prepubertal age but was se en in none of the children who had reached pubertal age. Conclusion Gr owth impairment and GH deficiency are common in children treated for m alignant brain tumours. The response to GH therapy is good in prepuber tal children in terms of increased growth velocity, although the final height is not yet known.