{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T18:57:48Z","timestamp":1775588268635,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T00:00:00Z","timestamp":1602288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To determine the impact of hypothalamic\u2010pituitary (HP) disorders on health outcomes in children and adolescents who received conformal radiation therapy (RT) for central nervous system tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Cohort study including 355 patients (age \u226425 years at diagnosis) treated with high\u2010dose (50.4\u201059.4 Gy) RT using photons for low\u2010grade glioma or ependymoma. Patients (median age, 6.4 years at RT) received systematic endocrine follow\u2010up (median duration, 10.1 years; range, 0.1\u201019.6). Associations between HP disorders and adverse health outcomes were determined by multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence was 37.2% for growth hormone deficiency (GHD), 17.7% for gonadotropin deficiency (LH\/FSHD), 14.9% for thyroid\u2010stimulating hormone deficiency (TSHD), 10.3% for adrenocorticotropic hormone deficiency (ACTHD), and 12.6% for central precocious puberty (CPP). Hypothalamus mean dose \u2265 36\u00a0Gy was associated with higher odds of any deficiency. GHD was associated with short stature (OR 2.77; 95% CI 1.34\u20105.70), low bone mineral density (OR 3.47; 95% CI 1.16\u201010.40), and TSHD with dyslipidemia (OR 5.54; 95% CI 1.66\u201018.52). Patients with ACTHD and CPP had lower intelligence quotient scores, and memory scores were impaired in patients with GHD (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Treatment of GHD was not associated with increased risk for tumor recurrence, secondary tumors, or mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HP disorders occur frequently in patients receiving high\u2010dose RT and are related to physical and neurocognitive well\u2010being. Future studies are needed to assess whether further optimization of endocrine management yields better health outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28723","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T10:46:30Z","timestamp":1602326790000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Clinical impact of hypothalamic\u2010pituitary disorders after conformal radiation therapy for pediatric low\u2010grade glioma or ependymoma"],"prefix":"10.1002","volume":"67","author":[{"given":"Laura","family":"van Iersel","sequence":"first","affiliation":[{"name":"Division of Endocrinology St. Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Department of Pediatric Endocrinology Wilhelmina Children's Hospital  Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanneke M.","family":"van 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