Barnea Dana, Raghunathan Nirupa, Friedman Danielle Novetsky, Tonorezos Emily S
Oncology (Williston Park). 2015 Nov;29(11):849-55.
As care for the childhood cancer patient has improved significantly, there is an increasing incidence of treatment-related late effects. Obesity and type 2 diabetes mellitus are common and significant metabolic conditions in some populations of adult survivors of childhood cancer. Results from the Childhood Cancer Survivor Study and other large cohorts of childhood cancer survivors reveal that long-term survivors of acute lymphoblastic leukemia and those who received total body irradiation or abdominal radiotherapy are at highest risk. The potential mechanisms for the observed increase in risk, including alterations in leptin and adiponectin, pancreatic insufficiency, poor dietary habits, sedentary lifestyle, and perhaps changes in the composition of the gut microbiota, are reviewed. Discussion of exercise and diet intervention studies shows that further research about the barriers to a healthy lifestyle and other interventions in childhood cancer survivors is warranted.
随着对儿童癌症患者的护理有了显著改善，与治疗相关的晚期效应发生率正在上升。肥胖和2型糖尿病在一些儿童癌症成年幸存者群体中是常见且严重的代谢状况。儿童癌症幸存者研究及其他大量儿童癌症幸存者队列的结果显示，急性淋巴细胞白血病的长期幸存者以及接受全身照射或腹部放疗的患者风险最高。本文综述了观察到的风险增加的潜在机制，包括瘦素和脂联素的改变、胰腺功能不全、不良饮食习惯、久坐不动的生活方式，以及肠道微生物群组成的变化。对运动和饮食干预研究的讨论表明，有必要进一步研究儿童癌症幸存者健康生活方式的障碍及其他干预措施。
