Endocrine Comorbidities in Survivors of Childhood Brain Tumors: Insights from the Slovenian National Cohort.

Abstract

Introduction: Endocrine disorders present a major comorbidity in pediatric brain tumors and/or treatment-related damage, which results in impaired function of the hypothalamic-pituitary axes. The aim of the study was to assess the prevalence of endocrine disorders among a complete childhood brain tumor survivor cohort treated between 2008 and 2018 at our national center.

Methods: Children with primary brain tumors treated at the University Children's Hospital, University Medical Center Ljubljana, between 2008 and 2018 were included and evaluated by the endocrinologist in the years 2023/2024. Data on demographics, anthropometrics, tumor type, and therapy were gathered. The presence of endocrinopathies was determined by clinical examination and laboratory data.

Results: A total of 94 patients (mean age at the most recent follow-up 14.9 +/- 5.5 years, mean follow-up duration 8 +/- 3 years) were included in the study. At the time of final follow-up, 23% were diagnosed with an endocrine disorder. The most prevalent were hyposomatotropism, followed by central hypothyroidism, with panhypopituitarism affecting 10% of the cohort. Endocrine dysfunction was more frequently observed in survivors with tumors located in the suprasellar region, those who underwent radiotherapy, and those who presented with hydrocephalus. A significant decrease in height SDS was noted compared to baseline height at the time of treatment initiation (p < 0.02), with a more pronounced reduction among those who received craniospinal radiotherapy as part of the oncological treatment.

Conclusion: The findings highlight a high prevalence of endocrine disorders in childhood brain tumor survivors, particularly those with suprasellar or posterior fossa tumors, or those treated with radiotherapy. These results emphasize the need for regular and ongoing endocrine monitoring in this patient population following the completion of oncological treatment.