RTHP-40. ENDOCRINE AND METABOLIC ABNORMALITIES IN INTRACRANIAL GERM CELL TUMOR PATIENTS TREATED WITH IRRADIATION

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2018-11, Vol.20 (suppl_6), p.vi233-vi233
• Main Authors: Boni, Xiang, Hongying, Ye, Yang, Wang
• Format: Article
• Language: English
• Subjects: Abstracts
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/noy148.969

Abstract OBJECTIVE To evaluate the endocrine and metabolic abnormalities in intracranial germ cell tumor (iGCT) patients treated with irradiation. PATIENTS AND METHOD: Seventy-seven iGCT patients who had received radiotherapy and endocrine follow-up in Huashan Hospital between January, 2010 and July, 2017 were retrospectively analyzed, consisting of forty-nine germinomas and twenty-eight NGGCTs. The median doses for the whole brain, spine and primary tumor site were 30.6Gy, 30.6Gy and 50.0Gy. The median follow-up period was 50.0 months. Fifty-one patients had radiologically proved suprasellar/sellar lesions. Results The 5-year overall and recurrence-free survival rates were both 98.7%. The prevalence of central adrenal insufficiency (CAI), central hypothyroidism (CHT), central hypogonadism (CHG), hyperprolactinemia (HPL) and central diabetes insipidus (CDI) in those with radiologically proved suprasellar/sellar lesions was 71.4%, 70.0%, 73.5%, 48.4% and 70.2%, while that in patients without suprasellar/sellar lesions was 30.8%, 28.0%, 25.9%, 15.0% and 16.7% separately. Compared to that before irradiation, CAI, CHT and CHG wasn`t significantly improved while the overall level of prolactin and prevalence of CDI declined significantly (P=0.03 and 0.001). The irradiation dosage wasn`t significantly associated with the prevalence of CAI, CHT and CHG. Based on BMI, 30.4% were overweight and 3.0% were obesed in patients below 18 years old. 72.1% patients had dyslipidemia, with the abnormality of triglyceride most commonly. One patient developed diabetes mellitus after irradiation. The prevalence of hyperuricemia was 50.0%. The irradiation dosage wasn`t associated with BMI, triglyceride, total cholesterol LDL-c, HDL-c, HOMA-IR or serum uric acid level. CONCLUSION The prevalence of CAI, CHT, CHG, HPL and CDI was high in iGCTs patients, and those without suprasellar/sellar lesions may develop those endocrine abnormalities too. The post-irradiation level of prolactin and prevalence of CDI declined significantly. Metabolic abnormalities including overweight, dyslipidemia, and hyperuricemia were common in iGCTs patients. The irradiation dosage wasn`t associated with occurrence of hypopituitarism and those metabolic parameters.