Bone mineral density is compromised in very long-term survivors of irradiated childhood brain tumor
| Autor: | Tytti Pokka, Marja Ojaniemi, Päivi M. Lähteenmäki, Pekka Arikoski, Tiina Remes, V. Pekka Riikonen, Kirsti Sirkiä, Arja Harila-Saari, Mikko Arola, Heikki Rantala |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Adolescent Adverse outcomes MEDLINE 030209 endocrinology & metabolism ta3112 03 medical and health sciences Young Adult 0302 clinical medicine Absorptiometry Photon Bone Density Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Survivors Young adult Child Radiation Injuries Finland Bone mineral business.industry Brain Neoplasms Hematology General Medicine ta3122 ta3123 030220 oncology & carcinogenesis Child Preschool Female business Psychosocial Childhood brain tumor |
| Zdroj: | Acta oncologica (Stockholm, Sweden). 57(5) |
| ISSN: | 1651-226X |
| Popis: | The increase in the number of childhood brain tumor survivors warrants detailed research to increase our knowledge regarding the possible physical and psychosocial adverse outcomes of tumor and tumor therapy. The aim of this study was to evaluate the current bone health by measuring the bone mineral density (BMD) in irradiated, adult long-term survivors of childhood brain tumors.We studied a national cohort of 74 adult survivors of childhood brain tumors treated with irradiation in Finland between 1970 and 2008. Dual X-ray absorptiometry (DXA) was performed for the femoral necks, total hips, and lumbar spine. Laboratory tests were conducted for evaluating the pituitary, thyroid, and gonadal functions. The participants were interviewed, examined clinically, and the disease and treatment related data were retrieved from the patient files.One fourth of the patients (23.6%) had sex- and age-normalized z-scores below the expected range for age (z-score ≤ -2.0). Mean BMD scores were decreased in all the DXA measurement sites. Male sex was associated with low BMD (p .05), while body mass index (BMI) had a significant positive association with BMD (p .01). Mode of irradiation (with or without spinal irradiation) or inclusion of chemotherapy in the treatment did not affect BMD significantly. However, patients with a ventriculoperitoneal shunt had lower BMD than those without a shunt (p .05). Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were negatively associated with BMD in women (p .05). However, a higher cumulative dose of glucocorticoids during treatment was not associated with lower BMD, while low BMD was significantly associated with previous fractures in long bones.Low BMD should be taken in consideration in treatment of irradiated childhood brain tumor survivors especially in those with previous fractures in long bones. |
| Databáze: | OpenAIRE |
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