Bone mineral density is compromised in very long-term survivors of irradiated childhood brain tumor

Authors

  • Tiina M. Remes Department of Pediatrics and Adolescence, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
  • Pekka M. Arikoski Department of Pediatrics and Adolescence, Kuopio University Hospital, Kuopio, Finland
  • Päivi M. Lähteenmäki Department of Pediatrics and Adolescence, Turku University Hospital and Turku University, Turku, Finland
  • Mikko O. Arola Department of Pediatrics and Adolescence, Tampere University Hospital, Tampere, Finland
  • Tytti M.-L. Pokka Department of Pediatrics and Adolescence, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
  • V. Pekka Riikonen Department of Pediatrics and Adolescence, Kuopio University Hospital, Kuopio, Finland
  • Kirsti H. Sirkiä Department of Pediatrics and Adolescence, Helsinki University Hospital, Helsinki, Finland
  • Heikki M. J. Rantala Department of Pediatrics and Adolescence, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
  • Arja H. Harila-Saari Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
  • Marja K. Ojaniemi Department of Pediatrics and Adolescence, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland

DOI:

https://doi.org/10.1080/0284186X.2018.1431401

Abstract

Introduction: 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.

Material and methods: 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.

Results: 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.

Discussion: Low BMD should be taken in consideration in treatment of irradiated childhood brain tumor survivors especially in those with previous fractures in long bones.

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Published

2018-05-04

How to Cite

Remes, T. M. ., Arikoski, P. M. ., Lähteenmäki, P. M. ., Arola, M. O., Pokka, T. M.-L. ., Pekka Riikonen, V. ., … Ojaniemi, M. K. . (2018). Bone mineral density is compromised in very long-term survivors of irradiated childhood brain tumor. Acta Oncologica, 57(5), 665–674. https://doi.org/10.1080/0284186X.2018.1431401

Issue

Vol. 57 No. 5 (2018): Acta Oncologica

Section

Articles