J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://www.jofem.org

Original Article

Volume 12, Number 3, June 2022, pages 79-88

Growth Hormone Deficiency in Childhood Intracranial Germ Cell Tumor Survivors

Figure 2. Deficiencies in anterior pituitary hormones. Of the full cohort of evaluable iGCT survivors, the total number of cases with each anterior pituitary hormone deficiency that predated the iGCT diagnosis is shown in blue, and the total cases with each respective hormone deficiency detected after iGCT diagnosis is shown in orange.

**Table 1.** Characteristics of the iGCT Study Population
	Frequency (%)
These characteristics are reported on full study population (n = 129) except where restricted by information available in the medical records. ^aTumor histology missing for n = 9. ^bPrimary tumor site missing for n = 36. ^cMetastatic disease status missing for n = 47. ^dSurgery missing for n = 3. ^eChemotherapy missing for n = 5. ^fRadiation therapy missing for n = 5. ^gAutologous stem cell transplant missing for n = 2. iGCT: intracranial germ cell tumor; NGGCT: non-germinomatous germ cell tumor.
Age at diagnosis
0 - 14 years	85 (65.9)
15 - 19 years	44 (34.1)
Median age (interquartile range) (years)	13.3 (10.1 - 15.7)
Sex
Male	92 (71.3)
Female	37 (26.7)
Race/ethnicity
Non-Hispanic white	92 (71.3)
Black	4 (3.1)
Hispanic	10 (7.8)
Asian/Pacific Islander	9 (7.0)
Other/mixed	14 (10.9)
Histology^a
Germinoma	82 (68.3)
NGGCT	38 (31.7)
Primary tumor site^b
Suprasellar	39 (41.9)
Other	54 (58.1)
Metastatic disease at diagnosis^c
Yes	11 (13.4)
No	71 (86.6)
Surgery^d
Yes	89 (96.7)
No	3 (3.3)
Chemotherapy^e
Yes	73 (81.1)
No	17(18.9)
Radiation therapy^f
Yes	85 (94.4)
No	5 (5.6)
Autologous stem cell transplant^g
Yes	8 (8.6)
No	85 (91.4)

Table 1. Characteristics of the iGCT Study Population

Frequency (%)

These characteristics are reported on full study population (n = 129) except where restricted by information available in the medical records. ^aTumor histology missing for n = 9. ^bPrimary tumor site missing for n = 36. ^cMetastatic disease status missing for n = 47. ^dSurgery missing for n = 3. ^eChemotherapy missing for n = 5. ^fRadiation therapy missing for n = 5. ^gAutologous stem cell transplant missing for n = 2. iGCT: intracranial germ cell tumor; NGGCT: non-germinomatous germ cell tumor.

Age at diagnosis

0 - 14 years

85 (65.9)

15 - 19 years

44 (34.1)

Median age (interquartile range) (years)

13.3 (10.1 - 15.7)

Sex

Male

92 (71.3)

Female

37 (26.7)

Race/ethnicity

Non-Hispanic white

92 (71.3)

Black

4 (3.1)

Hispanic

10 (7.8)

Asian/Pacific Islander

9 (7.0)

Other/mixed

14 (10.9)

Histology^a

Germinoma

82 (68.3)

NGGCT

38 (31.7)

Primary tumor site^b

Suprasellar

39 (41.9)

Other

54 (58.1)

Metastatic disease at diagnosis^c

Yes

11 (13.4)

71 (86.6)

Surgery^d

Yes

89 (96.7)

3 (3.3)

Chemotherapy^e

Yes

73 (81.1)

17(18.9)

Radiation therapy^f

Yes

85 (94.4)

5 (5.6)

Autologous stem cell transplant^g

Yes

8 (8.6)

85 (91.4)

**Table 2.** Characteristics of Cases With GH Deficiency Before and After iGCT Diagnosis
	No GH deficiency, N (%)	Pre-diagnosis GH deficiency, N (%)	Post-diagnosis GH deficiency, N (%)	Chi-squared or Fisher’s P-value, pre- vs. no GH deficiency	Chi-squared or Fisher’s P-value, post- vs. no GH deficiency
Pre-GH deficiency is GH deficiency diagnosed before iGCT. Post-GH deficiency is GH deficiency diagnosis after iGCT. Analysis completed on n = 79. GH: growth hormone; iGCT: intracranial germ cell tumor; NGGCT: non-germinomatous germ cell tumor; N/C: not calculated.
Total	44 (55.7)	14 (17.7)	21 (26.6)
Age at diagnosis				0.21	0.07
0 - 14 years	23 (52.3)	10 (71.4)	16 (76.2)
15 - 19 years	21 (47.7)	4 (28.6)	5 (23.8)
Sex				0.09	0.36
Male	34 (77.3)	7 (50.0)	14 (66.7)
Female	10 (22.7)	7 (50.0)	7 (33.3)
Race/ethnicity				0.78	0.55
Non-Hispanic white	33 (75.0)	10 (71.4)	17 (81.0)
Black	1 (2.3)	0 (0.0)	1 (4.8)
Hispanic	3 (6.8)	2 (14.3)	0 (0.0)
Asian/Pacific Islander	5 (11.4)	2 (14.3)	1 (4.8)
Other/mixed	2 (4.6)	0 (0.0)	2 (9.5)
Primary tumor site				< 0.0001	< 0.0001
Suprasellar	5 (11.6)	13 (92.9)	15 (71.4)
Other	38 (88.4)	1 (7.1)	6 (28.6)
Histology				0.15	0.75
Germinoma	29 (69.1)	12 (92.3)	13 (65.0)
NGGCT	13 (31.0)	1 (7.7)	7 (35.0)
Surgery				N/C	N/C
Yes	43 (100.0)	13 (92.9)	19 (90.5)
No	0 (0.0)	1 (7.1)	2 (9.5)
Chemotherapy				N/C	0.72
Yes	36 (85.7)	11 (78.6)	17 (81.0)
No	6 (14.3)	3 (21.4)	4 (19.1)
Cumulative radiation dose				N/C	0.13
Low dose < 38 Gy	16 (55.2)	8 (66.7)	5 (27.8)
Medium dose 38 - 51 Gy	4 (13.8)	4 (33.3)	6 (33.3)
High dose 51+ Gy	9 (31.0)	0 (0.0)	7 (38.9)

Table 2. Characteristics of Cases With GH Deficiency Before and After iGCT Diagnosis

No GH deficiency, N (%)

Pre-diagnosis GH deficiency, N (%)

Post-diagnosis GH deficiency, N (%)

Chi-squared or Fisher’s P-value, pre- vs. no GH deficiency

Chi-squared or Fisher’s P-value, post- vs. no GH deficiency

Pre-GH deficiency is GH deficiency diagnosed before iGCT. Post-GH deficiency is GH deficiency diagnosis after iGCT. Analysis completed on n = 79. GH: growth hormone; iGCT: intracranial germ cell tumor; NGGCT: non-germinomatous germ cell tumor; N/C: not calculated.

Total

44 (55.7)

14 (17.7)

21 (26.6)

Age at diagnosis

0.21

0.07

0 - 14 years

23 (52.3)

10 (71.4)

16 (76.2)

15 - 19 years

21 (47.7)

4 (28.6)

5 (23.8)

Sex

0.09

0.36

Male

34 (77.3)

7 (50.0)

14 (66.7)

Female

10 (22.7)

7 (50.0)

7 (33.3)

Race/ethnicity

0.78

0.55

Non-Hispanic white

33 (75.0)

10 (71.4)

17 (81.0)

Black

1 (2.3)

0 (0.0)

1 (4.8)

Hispanic

3 (6.8)

2 (14.3)

0 (0.0)

Asian/Pacific Islander

5 (11.4)

2 (14.3)

1 (4.8)

Other/mixed

2 (4.6)

0 (0.0)

2 (9.5)

Primary tumor site

< 0.0001

Suprasellar

5 (11.6)

13 (92.9)

15 (71.4)

Other

38 (88.4)

1 (7.1)

6 (28.6)

Histology

0.15

0.75

Germinoma

29 (69.1)

12 (92.3)

13 (65.0)

NGGCT

13 (31.0)

1 (7.7)

7 (35.0)

Surgery

N/C

Yes

43 (100.0)

13 (92.9)

19 (90.5)

0 (0.0)

1 (7.1)

2 (9.5)

Chemotherapy

N/C

0.72

Yes

36 (85.7)

11 (78.6)

17 (81.0)

6 (14.3)

3 (21.4)

4 (19.1)

Cumulative radiation dose

N/C

0.13

Low dose < 38 Gy

16 (55.2)

8 (66.7)

5 (27.8)

Medium dose 38 - 51 Gy

4 (13.8)

4 (33.3)

6 (33.3)

High dose 51+ Gy

9 (31.0)

0 (0.0)

7 (38.9)

**Table 3.** Predictors of GH Deficiency After iGCT Diagnosis
Risk factors	Post-GH deficiency	No GH deficiency	Unadjusted odds ratio (95% CI)	Chi-squared P-value	Adjusted odds ratio (95% CI)	Chi-squared P-value
GH: growth hormone; iGCT: intracranial germ cell tumor; CI: confidence interval.
Age at diagnosis
0 - 14 years	16	23	2.92 (0.91 - 9.37)	0.07	4.87 (0.74 - 32.04)	0.10
15 - 19 years	5	21	Ref		Ref
Tumor site
Suprasellar	15	5	19.00 (5.03 - 71.74)	< 0.0001	38.66 (3.45 - 436.21)	0.003
Other	6	38	Ref
Radiation dose, high vs. low
Low dose < 38 Gy	5	16	Ref		Ref
High dose 51+ Gy	7	9	2.49 (0.61 - 10.18)	0.84	9.03 (0.68 - 119.5)	0.33
Medium 38 - 51 Gy	6	4	4.80 (0.95 - 24.14)	0.13	10.68 (0.93 - 122.86)	0.19

Table 3. Predictors of GH Deficiency After iGCT Diagnosis

Risk factors

Post-GH deficiency

No GH deficiency

Unadjusted odds ratio (95% CI)

Chi-squared P-value

Adjusted odds ratio (95% CI)

Chi-squared P-value

GH: growth hormone; iGCT: intracranial germ cell tumor; CI: confidence interval.

Age at diagnosis

0 - 14 years

2.92 (0.91 - 9.37)

0.07

4.87 (0.74 - 32.04)

0.10

15 - 19 years

Ref

Tumor site

Suprasellar

19.00 (5.03 - 71.74)

< 0.0001

38.66 (3.45 - 436.21)

0.003

Other

Ref

Radiation dose, high vs. low

Low dose < 38 Gy

Ref

High dose 51+ Gy

2.49 (0.61 - 10.18)

0.84

9.03 (0.68 - 119.5)

0.33

Medium 38 - 51 Gy

4.80 (0.95 - 24.14)

0.13

10.68 (0.93 - 122.86)

0.19