Brain Irradiation for Childhood Cancer - Endocrine Monitoring During the First Years

Summary

BICHE- 1: Brain Irradiation for Childhood cancer - Endocrine monitoring during the first five years is a study of endocrine monitoring after cerebral radiotherapy. The study concerns patients in remission at the end of oncological treatment aged between 4 and 18 years at the time of inclusion and who have had radiotherapy before the age of 16, irradiating all or part of the brain, with a delay between the end of radiotherapy and inclusion of less than 5 years. Patients will be included during a routine visit to the paediatric endocrinologist. The protocol for the Biche 1 study has been designed and discussed in a multidisciplinary and multicentre manner, based on data from the literature and the French reference document (September 2021) "National protocol for diagnosis and care - congenital pituitary deficiency". In this population, the investigators will conduct a descriptive and exploratory study to establish recommendations for medium-term follow-up; to improve screening for endocrine deficiencies affecting the hypothalamic-pituitary axis in order to improve patients' quality of life and state of health; and to better define dose-volume constraints on the axis. The study will also focus on better detection and characterisation of chronic fatigue as a potential sequela of pituitary deficiencies, in particular by means of a questionnaire assessing fatigue (PedsQL Multidimensional Fatigue scale) which will also be systematically administered and completed annually.The expected sample size is 100-150 patients treated for a brain tumour and 60-80 patients treated for another tumour but with an irradiation field covering all or part of the brain.

Eligibility

Inclusion Criteria:

* Patient aged 4 years or more (≥4) and less than 18 years (\<18) at inclusion
* Treated with radiotherapy to part or all of the brain for cancer or hematological malignancy before age 16 (≤15)
* Post-radiotherapy time less than or equal to 5 years (≤5)
* In remission of this pathology at the end of oncological treatments, or, with stable residual disease without treatment for 2 years or more (≥2)
* Signature of informed consent from parents or legal guardian
* Patient affiliated to the social security system or beneficiary of such a system

Exclusion Criteria:

* Patients who have relapsed or developed a second cancer with a post-treatment delay of \< 1 year
* Patient in palliative situation
* Brain irradiation with dosimetric data showing sparing of the hypothalamic-pituitary axis (Dmax hypothalamic-pituitary axis \< 15 Gy)
* Patient with a known hypothalamic-pituitary axis endocrine deficit prior to radiotherapy
* Refusal of child or parents

Conditions4

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