Final height and insulin-like growth factor-1 in children with medulloblastoma treated with growth hormone

Medulloblastoma is a highly malignant childhood brain tumor. Survival from medulloblastoma is increasing. This study was performed to examine growth outcomes, insulin-like growth factor-1(IGF-1), and response to growth hormone (GH) treatment in children with medulloblastoma. Retrospective analysis of 34 children treated with GH for medulloblastoma was performed. We evaluated serum IGF-1 and insulin-like growth factor binding protein-3 concentrations. Further, we examined growth status and changes with GH treatment according to treatment modality. GH deficiency was observed in 28 patients (82 %). The initial height at the start of GH treatment was −2.35 ± −1.53 standard deviation score (SDS) and increased to −1.85 ± −1.28 SDS by 1 year, −1.64 ± −1.46 SDS by 2 years, and −1.42 ± −1.49 SDS by 3 years after GH treatment. The final height was −1.54 ± −1.06 SDS. Gender, surgical method, tumor location, tumor size, and type of radiation did not correlate with height gain. A younger age at the initiation of GH treatment correlated with height gain. The initial serum IGF-1 concentration was −1.73 ± −0.42 and increased significantly to −0.74 ± −0.21 SDS by 1 year after GH treatment. The serum IGF-1 SDS increment correlated significantly with height gain. Beginning GH treatment at a younger age was an important prognostic factor for growth outcome. Serum IGF-1 increment correlated with height gain during GH treatment. Thus, early GH treatment and analysis of serum IGF-1 might be helpful for improving final height or growth outcome.