GH therapy improves height in childhood cancer survivors
Treatment with growth hormone therapy (GHT) among childhood cancer survivors (CCSs) increases height and may improve lipid profiles and quality of life, according to the results of a systematic review and meta-analysis. In addition, GHT does not appear to increase the risk of diabetes or the development of secondary tumours.
“[C]lose monitoring for such complications remains warranted due to uncertainty in the current evidence,” the authors cautioned.
Multiple databases were searched for randomized and observational studies. Pairs of independent reviewers selected studies and collected data. Outcomes across studies were pooled using random effects meta-analysis.
Twenty-nine observational studies at moderate-to-high risk of bias were included, of which 16 compared CCSs on GHT with those not on GHT (512 patients; GH dose, 0.3–0.9 IU/kg/week). A significant association existed between GHT and height gain (standard deviation score, 0.61; 95 percent CI, 0.08–1.13). Moreover, GHT did not significantly correlate with the occurrence of secondary tumours (odds ratio [OR], 1.10; 0.72–1.67) or tumour recurrence (OR, 0.57; 0.31–1.02).
Thirteen studies compared CCSs on GHT with normal age- or sex-matched controls or controls with idiopathic GHD or short stature. GHT was shown to be associated with either improved or unchanged risk of diabetes, lipid profiles and metabolic syndrome. GHT also correlated with improvements in quality of life.
“GH deficiency is common among CCSs with history of tumours, surgery and/or radiotherapy involving the hypothalamus-pituitary region,” the authors noted.