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Adult Height and Adult Sitting Height in Childhood Medulloblastoma Survivors

Divisions of Endocrinology (W.X., T.M.) and Neurology and Oncology (A.J.), Department of Pediatrics, University of Pennsylvania, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania 19104

Address all correspondence and requests for reprints to: Thomas Moshang, Jr., M.D., Division of Endocrinology, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, Pennsylvania 19104. E-mail: moshang{at}e-mail.chop.edu.

Outcome in adult height and sitting height is poor in children surviving medulloblastoma due to craniospinal irradiation (CSRT) and chemotherapy. We evaluated adult height and sitting height in 51 medulloblastoma patients stratified into four groups: G1, GH-deficient (GHD) patients treated with 23–39 Gy CSRT but not treated with GH [recombinant human (rh)GH]; G2, patients treated with rhGH; G3, patients who were not GHD; and G4, patients treated with 18 Gy CSRT and rhGH. Standing/sitting height of each group was compared with parental height and previously reported outcome studies. The rhGH dose was 0.3 mg/kg·wk, a higher dose compared with other reports of adult heights. The adult heights were significantly taller in group G2 [mean height SD score (SDS) = -1.86] than that achieved in previous studies (P < 0.0001), but not different from group G3, non-GHD (mean SDS = -1.55). The tallest stature achieved was in group G4 (18 Gy CSRT), a height SDS of -1.01. Sitting heights were significantly less than the normal population, with mean SDS of -2.96 but -1.62 in group G4. We conclude that adult heights but not sitting heights in medulloblastoma survivors are significantly improved with the higher dose of rhGH. The lower dose of CSRT further improves not only adult height but also sitting height.

This manuscript was presented in part at the Annual Meeting of the Pediatric Academic Societies held in Baltimore, MD, May 4–7, 2002, and the 84th Annual Meeting of The Endocrine Society in San Francisco, CA, June 18–22, 2002.

Abbreviations: CHOP, Children’s Hospital of Philadelphia; CSRT, craniospinal radiation therapy; GHD, GH deficient or deficiency; GHRT, GH replacement therapy; rh, recombinant human; SDS, SD score(s).

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