Prevalence and Risk Factors of Hypothalamic-Pituitary Dysfunction in Infant and Toddler Brain Tumor Survivors

Abstract Background: Childhood brain tumor survivors (CBTS) are at risk for hypothalamic-pituitary (HP) dysfunction, mainly caused by radiation exposure or involvement of the HP-region. The HP dysfunction (HPD) may vary between different age groups due to maturation and differences in oncologic treatment protocols. aim this study was determine prevalence factors HPD infant (IBTS) toddler (TBTS) compared older childhood (OCBTS). Patients Methods: A retrospective analysis a nationwide cohort CBTS performed. Prevalence were IBTS (aged 0-1 years diagnosis), TBTS 1-3 diagnosis) OCBTS >3-18 diagnosis). Results: In 718 included CBTS, with median follow-up time 7.9 years, overall no percentage found three groups. Treatment radiotherapy (RT) (OR 15.41; 95%CI 8.33 28.48), suprasellar location 46.62; 19.64 110.66) younger 1.09; 1.02 1.15) associated dysfunction. Because significantly less often treated RT, subanalyses performed all not (n=459). non-irradiated more frequently diagnosed TSH-, ACTH- ADH deficiency, ECBTS. showed weight gain (p<0.0001) smaller height SDS (p=0.001) during follow-up. Conclusion: Infant seem be vulnerable develop than when children. These results emphasize importance special toddlers protocols endocrine surveillance children young age.