뇌종양 환아에서 성장호르몬 치료 후 뇌종양 재발증가에 관한 연구

Abstract

Purpose Growth hormone (GH) has been used successfully in the treatment of short stature secondary to GH deficiency in survivors of childhood brain tumors. There has been concerned that GH might increase the risk of tumor recurrence in spite of improvement of growth.

Methods Data for tumor recurrence from 1997 to 2006 were analysed retrospectively in 56 patients with craniopharyngioma, 78 patients with medulloblastomas, 14 patients with germinomas and 139 patients with astrocytomas or gliomas after GH treatment. Serum insulin-like growth factor (IGF)-1 and IGF binding protein (IGFBP)-3 were measured.

Results 57 GH deficient and growth retarded patients (17.4%) were treated with recombinant human GH and followed up 60 months after starting GH treatment. 6 patients (10.5%) (5 craniopharyngioma, 1 germinoma) were recurred among patients with GH therapy, but 17 patients (5.2%) were recurred among patients with non GH therapy. Tumor recurrence in GH treated group was not higher than in non GH treated group. There was no significant change in serum IGF-1, IGFBP-3 level and IGF-1/IGFBP-3 ratio.

Conclusion Tumor recurrence rates in surviving patients with brain tumors receiving GH treatment do not appear to be increased compared with non GH treatment. However, longer follow-up regarding recurrences and secondary neoplasms remains to be essential.