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General and acute paediatrics
Growth hormone and segmental growth in survivors of head and neck embryonal rhabdomyosarcoma
  1. J R Katza,
  2. P Bareillea,
  3. G Levittb,
  4. R Stanhopea
  1. aDepartment of Endocrinology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK, bDepartment of Haematology and Oncology, Great Ormond Street Hospital for Children
  1. Dr R Stanhope, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UKR.Stanhope{at}ich.ucl.ac.uk

Abstract

AIMS To assess the impact of treatment for embryonal rhabdomyosarcoma on spinal growth and limb length and examine the response of these parameters to growth hormone (GH) treatment.

METHODS We conducted a retrospective case note review of 17 survivors of head and neck rhabdomyosarcoma followed up at a single institution. All children had been treated with chemotherapy and local radiotherapy. Growth velocity, height, sitting height, and subischial limb length SDS scores were analysed.

RESULTS Growth failure secondary to isolated GH deficiency (GHD) developed in 7/17 patients. GHD occurred at a median (range) of 3.4 (1.3–9.9) years after radiotherapy tumour doses of 46 (40–50) Gy. Growth velocity, height, and subischial limb length SDS were significantly reduced in the GHD group and improved with GH therapy.

CONCLUSIONS GH treatment resulted in a significant improvement in sitting height SDS. We discuss the unexpected improvement in spinal growth in survivors with GHD.

  • rhabdomyosarcoma
  • pituitary function
  • growth hormone

https://doi.org/10.1136/adc.84.5.436

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