Endocrine Abstracts

Systematic collections of neuroimaging data are rare in brain tumour survivors treated with adult growth hormone replacement therapy (AGHRT). In 1993, our unit implemented a policy of performing baseline brain scans on every brain tumour survivor before starting AGHRT, with repeat neuroimaging at least once after 12 to 18 months treatment. This retrospective study analyses the neuroimaging results for this cohort of 60 patients. Follow-up scans were available in 41 (91%) of those 45 patients, who received AGHRT for more than one year. Sixteen patients had residual tumours, and second neoplasms (SN) (mainly meningiomas) were demonstrated in four patients on baseline scans. Of the 16 residual primary tumors at baseline, one meningioma progressed slightly in size over 7.7 years, and an incurable ependymoma continued to grow. Follow-up scans also revealed five additional meningiomas (three in patients with a previous SN, confirming an excess risk in this subgroup), occuring with an average delay of 23 years after radiotherpay. All four SNs detected at baseline progressed in size, whereas no disease recurrence or progression was demonstrated in the remaining 30 patients (73%). Our data do not suggest an increased rate of tumour recurrence, tumour progression or intracranial SNs in brain tumour survivors treated with AGHRT. They confirm the need for vigilance even decades after initial tumour treatment, and support a proactive neuroimaging policy in this cohort, preferably as part of larger controlled trials in the future.