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[两名接受急性淋巴细胞白血病治疗儿童的化疗和放疗晚期效应]

[Late effects of chemo- and radiotherapy in two children treated for acute lymphoblastic leukemia].

作者信息

Balcerska A, Birkholz D

机构信息

Kliniki Pediatrii, Hematologii, Onkologii i Endokrynologii Akademii Medycznej w Gdańsku.

出版信息

Wiad Lek. 1998;51 Suppl 4:289-95.

Abstract

UNLABELLED

The endocrinological disorders are known sequelae of cancer therapy. The aim of our study was to evaluate the effects of chemo- and radiotherapy on growth and auxiological parameters in children treated for acute lymphoblastic leukaemia (ALL) since 1984 to 1996. We studied growth, pubertal development and endocrine functions in 32 patients who were treated for ALL. Two of them had endocrine abnormalities. Both took a different course of disease and treatment because of local relapse in uterus (the girl) and in testis (the boy). All patients received cranial preventive radiotherapy but two of them also received: abdominal irradiation (the girl) and direct testicular irradiation (the boy) with total doses 24 Gy. The girl had clinical and biochemical symptoms of primary thyroid failure, growth hormone deficiency and hypergonadotropic hypogonadism recognized after 8 years following the completion of therapy. The boy had biochemical symptoms of hypogonadism with low serum testosterone concentration responses to stimulation with human gonadotropin after 4 years of remission.

CONCLUSION

We suggest that clinical and biochemical assessment of endocrinological functions including growth, pubertal development, thyroid function should be performed at regular intervals following chemotherapy and radiotherapy in patients with acute lymphoblastic leukaemia and another carcinomas.

摘要

未标注

内分泌紊乱是癌症治疗已知的后遗症。我们研究的目的是评估1984年至1996年期间接受急性淋巴细胞白血病(ALL)治疗的儿童化疗和放疗对生长及人体测量学参数的影响。我们研究了32例接受ALL治疗患者的生长、青春期发育和内分泌功能。其中2例有内分泌异常。由于子宫局部复发(女孩)和睾丸局部复发(男孩),两人的疾病和治疗过程不同。所有患者均接受了颅脑预防性放疗,但其中2例还接受了:腹部照射(女孩)和睾丸直接照射(男孩),总剂量为24 Gy。女孩在治疗结束8年后出现原发性甲状腺功能减退、生长激素缺乏和高促性腺激素性性腺功能减退的临床和生化症状。男孩在缓解4年后出现性腺功能减退的生化症状,血清睾酮浓度对人促性腺激素刺激的反应较低。

结论

我们建议,对于急性淋巴细胞白血病和其他癌症患者,化疗和放疗后应定期进行包括生长、青春期发育、甲状腺功能在内的内分泌功能的临床和生化评估。

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