Risk of meningioma in European patients treated with growth hormone in childhood: results from the SAGhE cohort

Anthony J Swerdlow, Rosie Cooke, Dominique Beckers, Gary Butler, Jean-Claude Carel, Stefano Cianfarani, Peter Clayton, Joël Coste, Annalisa Deodati, Emmanuel Ecosse, Anita C S Hokken-Koelega, Aysha J Khan, Wieland Kiess, Claudia E Kuehni, Christa E Flück, Roland Pfaffle, Lars Sävendahl, Grit Sommer, Muriel Thomas, Anders TidbladSally Tollerfield, Gladys R J Zandwijken

Research output: Contribution to journalArticlepeer-review

Abstract

Context: There has been concern that growth hormone (GH) treatment of children might increase meningioma risk. Results of published studies have been inconsistent and limited.

Objective: To examine meningioma risks in relation to GH treatment.

Design: Cohort study with follow-up via cancer registries and other registers.

Setting: Population-based.

Patients: A cohort of 10,403 patients treated in childhood with recombinant GH (r-hGH) in 5 European countries since this treatment was first used in 1984. Expected rates from national cancer registration statistics.

Main Outcome Measures: Risk of meningioma incidence.

Results: During follow-up 38 meningiomas occurred. Meningioma risk was greatly raised in the cohort overall (SIR=75.4; 95% confidence interval (CI) 54.9-103.6), as a consequence of high risk in subjects who had received radiotherapy for underlying malignancy (SIR= 658.4; 95% CI 460.4-941.7). Risk was not significantly raised in patients who did not receive radiotherapy. Risk in radiotherapy-treated patients was not significantly related to mean daily dose of GH, duration of GH treatment or cumulative dose of GH.

Conclusions: Our data add to evidence of very high risk of meningioma in patients treated in childhood with GH after cranial radiotherapy, but suggest that GH may not affect radiotherapy-related risk, and that there is no material raised risk of meningioma in GH-treated patients who did not receive radiotherapy.

Original languageEnglish
JournalThe Journal of clinical endocrinology and metabolism
DOIs
Publication statusE-pub ahead of print - Aug 17 2018

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