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GH replacement therapy and second neoplasms in adult survivors of childhood cancer: a retrospective study from a single institution

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Abstract

Purpose

Growth hormone deficiency (GHD) is the most common endocrine late effect observed in childhood cancer survivors (CCS) previously submitted to cranial irradiation. Radiation therapy can also increase the risk of second neoplasms (SNs). Since in previous studies GH replacement therapy was associated with increased incidence of neoplasia, we explored the association between SNs and GH replacement therapy in a cohort of CCS with GHD.

Methods

Within the clinical cohort of CCS referred to the Transition Unit for Childhood Cancer Survivors of Turin between November 2001 and December 2012, we considered all patients who developed GHD as a consequence of cancer therapies. GHD was always diagnosed in childhood. To evaluate the quality of data, our cohort was linked to the Childhood Cancer Registry of Piedmont.

Results

GHD was diagnosed in 49 out of 310 CCS included in our clinical cohort. At least one SN was diagnosed in 14 patients, meningioma and basal cell carcinoma being the most common SNs. The cumulative incidence of SNs was similar in GH-treated and -untreated patients (8 SNs out of 26 GH-treated and 6 out of 23 GH-untreated patients; p = 0.331). Age, sex and paediatric cancer type had no impact on SNs development.

Conclusions

In our CCS, GH replacement therapy does not seem to increase the risk of SNs. Anyway, independently from replacement therapy, in these patients we observed an elevated risk of SNs, possibly related to previous radiation therapy, which suggests the need of a close long-term follow-up.

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Acknowledgments

The authors would like to acknowledge U.G.I. (Unione Genitori Italiani contro il tumore dei bambini), for the ongoing support to clinical and research activities of the Transition Unit for Childhood Cancer Survivors, and Dr. Fulvio Lazzarato, for his skilful collaboration in data management. This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Via Cherasco, 15, 10126, Turin, Italy

    E. Brignardello, F. Felicetti & N. Fortunati

  2. Oncological Endocrinology Unit, Department of Oncology, University of Torino, Turin, Italy

    F. Felicetti, N. Fortunati & E. Arvat

  3. Unit of Clinical Epidemiology, University of Torino and Centre for Cancer Epidemiology and Prevention (CPO Piemonte), Turin, Italy

    A. Castiglione & C. Sacerdote

  4. Paediatric Endocrinology Unit, Department of Paediatric Sciences, Città della Salute e della Scienza Hospital, Turin, Italy

    P. Matarazzo & A. Corrias

  5. Paediatric Hematology/Oncology Unit, Department of Paediatric Sciences, Città della Salute e della Scienza Hospital, Turin, Italy

    E. Biasin & F. Fagioli

  6. Radiation Oncology Unit, Department of Oncology, University of Torino, Turin, Italy

    U. Ricardi

Authors
  1. E. Brignardello
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  2. F. Felicetti
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  3. A. Castiglione
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  4. N. Fortunati
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  8. U. Ricardi
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  9. F. Fagioli
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  11. E. Arvat
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Corresponding author

Correspondence to E. Brignardello.

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Brignardello, E., Felicetti, F., Castiglione, A. et al. GH replacement therapy and second neoplasms in adult survivors of childhood cancer: a retrospective study from a single institution. J Endocrinol Invest 38, 171–176 (2015). https://doi.org/10.1007/s40618-014-0179-1

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  • DOI: https://doi.org/10.1007/s40618-014-0179-1

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