Emory University School of Medicine, Department of Pediatrics, M.S., Emory Children's Center, 2015 Uppergate Drive, Suite 232 NE, Atlanta, Georgia 30322, USA.
J Clin Endocrinol Metab. 2012 Mar;97(3):810-8. doi: 10.1210/jc.2011-2104. Epub 2011 Dec 21.
Many pediatric cancer survivors have endocrine conditions. Surveillance for late effects is recommended by national guidelines. Endocrine surveillance is recommended after alkylating agents, steroids, methotrexate, and radiation.
The objective of the study was to describe the endocrine outcomes in patients followed up in a program that uses national screening guidelines.
The design of the study was a medical records review.
The study was conducted in the Comprehensive Cancer Survivor Program, an academic pediatric oncology program.
The study included 519 pediatric and young adult survivors of noncentral nervous system childhood malignancies between January 1, 2001, and December 15, 2005.
Patients were evaluated with history, physical examinations, and evaluations recommended in the Children's Oncology Group's Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers.
The frequency and types of endocrine conditions were measured.
Four hundred eighty endocrine conditions were observed in 299 survivors (57.6% of survivors). The most common types of endocrine conditions were problems with weight and gonadal function. In a Cox regression model, stem cell transplant, radiation, and older age at cancer diagnosis were associated with higher hazard of an endocrine condition. Radiation, stem cell transplant, and sarcoma diagnosis were associated with growth problems.
Endocrine disorders were common after pediatric cancers. Endocrinologists should be aware of national guidelines, anticipate referral of pediatric cancer survivors, and participate in further research to optimize screening for and treatment of endocrine effects of cancer therapy.
许多儿科癌症幸存者存在内分泌问题。国家指南建议对晚期影响进行监测。建议在使用烷基化剂、类固醇、甲氨蝶呤和放射治疗后进行内分泌监测。
本研究的目的是描述在遵循国家筛查指南的方案中接受随访的患者的内分泌结果。
本研究为病历回顾。
本研究在综合癌症幸存者计划中进行，该计划是一个学术性儿科肿瘤学计划。
本研究包括 2001 年 1 月 1 日至 2005 年 12 月 15 日期间患有非中枢神经系统儿童期恶性肿瘤的 519 名儿科和年轻成年幸存者。
患者接受病史、体格检查和儿童肿瘤学组幸存者儿童、青少年和年轻成人癌症长期随访指南中建议的评估。
在 299 名幸存者中观察到 480 种内分泌疾病（57.6%的幸存者）。最常见的内分泌疾病类型是体重和性腺功能问题。在 Cox 回归模型中，干细胞移植、放疗和癌症诊断时年龄较大与更高的内分泌疾病风险相关。放疗、干细胞移植和肉瘤诊断与生长问题相关。
儿科癌症后内分泌疾病很常见。内分泌学家应了解国家指南，预计将儿科癌症幸存者转介，并参与进一步的研究，以优化癌症治疗内分泌影响的筛查和治疗。
