Growth Hormone Deficiency in Childhood Intracranial Germ Cell Tumor Survivors

Diana W Lone, Karim T. Sadak, Bradley S Miller, Jeannette M. Sample, Aubrey K Hubbard, Caryn Wolter, Michelle A Roesler, Michelle Nuno, Jen Poynter

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1 Scopus citations


Background: Intracranial germ cell tumor (iGCT) survivors have multiple risk factors for growth hormone (GH) deficiency, a commonly reported late effect in childhood cancer survivors. The objective of this study was to examine the prevalence of GH deficiency among childhood iGCT survivors. Methods: Participants were previously enrolled in the Germ Cell Tumor Epidemiology Study (GaMETES), a case-parent triad study conducted using the Children’s Oncology Group registry protocols, including 216 cases with iGCTs. Data on late effects and outcomes are available for 129 iGCT cases who consented for a follow-up study including a self-administered questionnaire and medical record retrieval. GH deficiency was identified via self-report and validated through medical record review. Chi-squared and Fisher’s exact tests were used to examine cases with GH deficiency predating iGCT detection. Logistic regression was used to identify predictors of GH deficiency as a late effect. Results: Of 129 iGCT cases who participated in the late effects study, 45% had GH deficiency, 18% had GH deficiency predating the iGCT, and 27% developed GH deficiency within a median of 19 months after diagnosis. Younger age at diagnosis, suprasellar location, and higher radiation doses were associated with GH deficiency as a late effect. Conclusions: GH deficiency is highly prevalent as an early clinical sign for iGCT and frequently arises as an early late effect after treatment. Additional investigation is needed to address earlier detection and treatment for this highly prevalent late effect in iGCT survivors.

Original languageEnglish (US)
Pages (from-to)79-88
Number of pages10
JournalJournal of Endocrinology and Metabolism
Issue number3
StatePublished - Jun 2022

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (NIH, T32 CA099936 to DL; R01 CA151284 to JNP; NCTN Operations Center Grant (U10 CA180886); and NCTN Statistics & Data Center Grant (U10CA180899), and the Children’s Cancer Research Fund, Minneapolis, MN.

Publisher Copyright:
© The authors.


  • Growth hormone deficiency
  • Intracranial germ cell tumor
  • Late effects

PubMed: MeSH publication types

  • Journal Article


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