Endocrine Abstracts

Brain tumours are the most common solid tumour in children, affecting 400 children in the UK each year. The aggressive treatment required for cure, may have serious consequences, of which endocrine late effects are the most prevalent.

This aim of this audit is to ascertain the frequency and nature of endocrine late effects; in a cohort of 30 survivors, diagnosed over a fourteen year period. Data was collected on tumour site, histology, treatments used and endocrine complications.

75% of children underwent surgery, 89% received chemotherapy, 39% received cranial radiotherapy, 26% received craniospinal radiotherapy and 18% children received both cranial & craniospinal radiotherapy.

57% of survivors were referred to the Endocrine clinic, at a mean duration of 1 year following end of treatment.

29% of survivors were diagnosed with GH deficiency (87.5% of these children had received radiotherapy). Impaired spinal growth was seen in all children who received craniospinal radiotherapy. 18% of children were found to have a suboptimal cortisol response; necessitating emergency hydrocortisone treatment. 11% of survivors developed hypothyroidism; all of these children had received radiotherapy. Onset of hypothyroidism ranged from at completion of treatment to 5 years following treatment. 11% of survivors were diagnosed with precocious puberty; which in 1 case had masked a GH deficiency.

In conclusion, this audit confirms the high prevalence of endocrine late effects in survivors of childhood brain tumours. Data support the establishment of a joint oncology and endocrinology late effects clinic; to ensure early identification and treatment of these serious complications.