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Minerva Pediatrics 2022 Feb 10

DOI: 10.23736/S2724-5276.22.06799-4


language: English

Growth Hormone replacement therapy in pediatric brain tumor survivors

Giorgio SODERO 1, Pierpaolo AGRESTI 1, Silvia TRIARICO 2, Alberto ROMANO 1, Stefano MASTRANGELO 2, 3, Giorgio ATTINÀ 2, Palma MAURIZI 2, Clelia CIPOLLA 4, Antonio RUGGIERO 2, 3

1 Istituto di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy; 2 Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy; 3 Università Cattolica del Sacro Cuore Sede di Roma, Italy; 4 Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy


Brain tumors are the most frequent type of solid neoplasms in children with a recognized 5-year survival rate between 57 and 65%. The survival rate progressively increased in the last few years, due to the improvements in their treatment based on chemotherapy, radiotherapy, and surgery. At the same time, at long term follow-up, clinicians should carefully evaluate comorbidities and long term sequelae secondary to the disease and its treatment. Growth Hormone Deficiency (GHD) is an endocrinopathy commonly found among pediatric cancer survivors, with a negative effect on the child's final height and entire metabolism. GH replacement therapy (GHRT), with a synthetic hormone analog, may improve the growth rate and finally adult height, ameliorating the quality of life after cancer treatment. However, in clinical practice, GHRT is adopted with caution for fear of cancer recurrence or the onset of second malignancies. In our review, we perform a focus on the GH structure and function, comparing benefits and risks of GHRT, derived from the analysis of the data currently available in the literature.

KEY WORDS: Brain tumors; Pediatric tumor survivors; Growth hormone (GH); Insulin-like growth factor-1 (IGF-1); Growth hormone deficiency (GHD); Growth hormone replacement therapy (GHRT)

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