Endocrine and Metabolic Late Effects After Childhood Brain Tumor Treatment

Survival after primary brain tumors diagnosed in childhood has improved substantially. However, survivors may develop long-term endocrine, metabolic, neurological, psychological, and cardiovascular complications. These late effects may appear several years after completion of treatment and may negatively affect health, quality of life, and life expectancy.

This prospective single-group study includes individuals who were treated for a primary brain tumor in Slovenia between 2008 and 2018 while aged 0 to 18 years and who survived for at least 5 years after diagnosis.

Participants undergo a standardized multidisciplinary late-effects assessment during follow-up by oncology, neurology, and endocrinology specialists. Information on tumor type and location, age at diagnosis, treatment modalities, date of treatment completion, current therapy, and relevant late effects is collected from medical records and clinical evaluation.

The assessment includes body weight, height, waist and hip circumference, arm span, sitting height, repeated blood pressure measurements, and clinical assessment of pubertal development when applicable. Endocrine and metabolic laboratory parameters may include growth-related hormones, thyroid hormones, gonadotropins, sex hormones, cortisol, insulin, glucose, lipid profile, liver enzymes, vitamin D, and other clinically relevant markers.

Where available or clinically indicated, the assessment also includes bone mineral density and body composition measurement by dual-energy X-ray absorptiometry, carotid intima-media thickness measurement, and evaluation of arterial stiffness by pulse wave velocity. No investigational medicinal product is administered.

The primary objective is to determine the occurrence and severity of endocrine and metabolic late effects after treatment of childhood brain tumors. Additional analyses evaluate associations between these late effects and tumor location, tumor type, treatment modality, age at diagnosis, and physical functioning.

The results are intended to support the identification of survivors at increased risk and to contribute to the development of individualized long-term monitoring, prevention, and treatment strategies.

Inclusion criteria

• Individuals treated for a primary brain tumor in Slovenia between 2008 and 2018 while aged 0 to 18 years.
• Survival for at least 5 years after the diagnosis of a primary brain tumor.
• Written informed consent provided by the participant or, when applicable, by a parent or legal guardian.

Exclusion criteria

• Failure to meet the inclusion criteria.
• Absence of written informed consent from the participant or, when applicable, from a parent or legal guardian.