Growth hormone deficiency following radiotherapy for orbital and parameningeal sarcomas

Growth hormone deficiency (GHD) is a recognized late effect of successful t reatment of tumors requiring cranial irradiation. Growth after treatment wa s assessed in 16 patients with sarcomas of the orbital and parameningeal re gions. Median age at diagnosis was 6.35 years and median follow-up was 7.2 years. Treatment consisted of combination chemotherapy and radical radiothe rapy, conventionally fractionated with a median dose 4500 cGy; the hypothal amic/pituitary region received a median dose of 4163 cGy. Height was measur ed every 6 months and 13/16 patients underwent tests of GH function. At GH testing median height standard deviation score (SDS) was -0.7 a median decr ease of -0.55 since tumor diagnosis. Seven patients were treated with human GH (hGH) at a median of 3.7 years from tumor diagnosis and followed for a median of 2.7 years. Treatment with hGH resulted in a median increase in he ight SDS of 0.9. Careful surveillance with timely introduction of GH replac ement is required for treatment of GHD following treatment of orbital and p arameningeal sarcomas.