Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysis

Objective: To evaluate the prevalence of growth hormone deficiency in patients who underwent cranial irradiation for brain tumors. Methods: Ovid Medline and Embase databases were used for review. Eligible studies were observational studies with brain tumor survivors who had growth hormone function e...

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Main Authors: Tatiana Tselovalnikova, Ben Ponvilawan, Maria G Pavlova, Cynthia Flanagan, Sunpreet S Rakhra, Betty M Drees
Format: Article
Language:English
Published: Bioscientifica 2025-07-01
Series:Endocrine Oncology
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Online Access:https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0025.xml
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author Tatiana Tselovalnikova
Ben Ponvilawan
Maria G Pavlova
Cynthia Flanagan
Sunpreet S Rakhra
Betty M Drees
author_facet Tatiana Tselovalnikova
Ben Ponvilawan
Maria G Pavlova
Cynthia Flanagan
Sunpreet S Rakhra
Betty M Drees
author_sort Tatiana Tselovalnikova
collection DOAJ
description Objective: To evaluate the prevalence of growth hormone deficiency in patients who underwent cranial irradiation for brain tumors. Methods: Ovid Medline and Embase databases were used for review. Eligible studies were observational studies with brain tumor survivors who had growth hormone function evaluated after treatment at age ≥18 years. Patient data on disease prevalence were pooled using the random-effect, generic inverse variance method. The presence of publication bias was determined by Egger’s test. Mann–Whitney U test, univariate and multivariate linear regression were used to determine the association and effect of covariates and growth hormone peak level. Results: After screening 3,355 relevant articles, seven studies were included. The pooled result showed that out of 3,489 patients who received radiation for brain tumors, regardless of age at the time of treatment, 50% developed growth hormone deficiency (95% CI 40–60%, I2 = 83%). Subgroup analysis based on the growth hormone peak level did not show differences between different cutoffs. Univariate linear regression using data from 27 patients showed that age at radiation and the time duration between radiation and the stimulation test (P = 0.03 and 0.002, respectively), but not radiation dose or sex, were significantly correlated with growth hormone peak level. After multivariate adjustment, only the time duration between radiation and the stimulation test was associated with decreased growth hormone peak level (P = 0.04). Conclusions: Half of brain tumor survivors develop growth hormone deficiency. A longer duration of follow-up is associated with higher risks of growth hormone deficiency. Lifelong follow-up is essential.
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spelling doaj-art-5e35b1d710f94254b903766f385b65ba2025-08-20T03:50:31ZengBioscientificaEndocrine Oncology2634-47932025-07-015110.1530/EO-25-00251Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysisTatiana Tselovalnikova0Ben Ponvilawan1Maria G Pavlova2Cynthia Flanagan3Sunpreet S Rakhra4Betty M Drees5University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USAUniversity of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USAFirst Moscow State Medical University (Sechenov University), Moscow, RussiaUniversity of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USASt. Luke’s Cancer Institute, Kansas City, Missouri, USAUniversity of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USAObjective: To evaluate the prevalence of growth hormone deficiency in patients who underwent cranial irradiation for brain tumors. Methods: Ovid Medline and Embase databases were used for review. Eligible studies were observational studies with brain tumor survivors who had growth hormone function evaluated after treatment at age ≥18 years. Patient data on disease prevalence were pooled using the random-effect, generic inverse variance method. The presence of publication bias was determined by Egger’s test. Mann–Whitney U test, univariate and multivariate linear regression were used to determine the association and effect of covariates and growth hormone peak level. Results: After screening 3,355 relevant articles, seven studies were included. The pooled result showed that out of 3,489 patients who received radiation for brain tumors, regardless of age at the time of treatment, 50% developed growth hormone deficiency (95% CI 40–60%, I2 = 83%). Subgroup analysis based on the growth hormone peak level did not show differences between different cutoffs. Univariate linear regression using data from 27 patients showed that age at radiation and the time duration between radiation and the stimulation test (P = 0.03 and 0.002, respectively), but not radiation dose or sex, were significantly correlated with growth hormone peak level. After multivariate adjustment, only the time duration between radiation and the stimulation test was associated with decreased growth hormone peak level (P = 0.04). Conclusions: Half of brain tumor survivors develop growth hormone deficiency. A longer duration of follow-up is associated with higher risks of growth hormone deficiency. Lifelong follow-up is essential.https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0025.xmlgrowth hormone deficiencybrain tumorcranial irradiationgrowth hormone
spellingShingle Tatiana Tselovalnikova
Ben Ponvilawan
Maria G Pavlova
Cynthia Flanagan
Sunpreet S Rakhra
Betty M Drees
Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysis
Endocrine Oncology
growth hormone deficiency
brain tumor
cranial irradiation
growth hormone
title Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysis
title_full Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysis
title_fullStr Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysis
title_full_unstemmed Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysis
title_short Prevalence of growth hormone deficiency in brain tumor survivors: a systematic review and meta-analysis
title_sort prevalence of growth hormone deficiency in brain tumor survivors a systematic review and meta analysis
topic growth hormone deficiency
brain tumor
cranial irradiation
growth hormone
url https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0025.xml
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