Felicetti Francesco, Fortunati Nicoletta, Arvat Emanuela, Brignardello Enrico
Transition Unit for Childhood Cancer Survivors, Department of Oncology, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126, Turin, Italy.
Transition Unit for Childhood Cancer Survivors, Department of Oncology, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126, Turin, Italy; Oncological Endocrinology Unit, Department of Oncology, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126, Turin, Italy.
Best Pract Res Clin Endocrinol Metab. 2016 Dec;30(6):795-804. doi: 10.1016/j.beem.2016.11.007. Epub 2016 Nov 17.
Childhood cancer survivors (CCS) are a fast growing population, but late adverse effects of cancer therapies are not rare. In CCS treated with cranial radiotherapy, growth hormone deficiency (GHD) is a well-known occurrence and the potential impact of GH replacement therapy on the global outcome of CCS is under continuous evaluation. In the present review, we discuss advantages and disadvantages of GH replacement therapy in survivors of pediatric malignancies, taking into consideration the different reasons for treating GHD during childhood or adult life. It is doubtless that GH treatment is advisable to obtain a normal growth in pediatric patients. As far as the beginning/continuation of the replacement therapy in adult age is concerned, contrasting results have been reported in literature. The suggestion is that the decision to treat adult CCS should be taken after careful evaluation of each patient's clinical history and of the potential side effects, in agreement with the patients.
儿童癌症幸存者（CCS）是一个快速增长的群体，但癌症治疗的晚期不良反应并不罕见。在接受颅脑放疗的CCS中，生长激素缺乏症（GHD）是一种常见情况，生长激素替代疗法对CCS整体预后的潜在影响正在持续评估中。在本综述中，我们讨论了儿童恶性肿瘤幸存者生长激素替代疗法的优缺点，同时考虑了在儿童期或成年期治疗GHD的不同原因。毫无疑问，生长激素治疗对于使儿科患者实现正常生长是可取的。就成年期替代疗法的开始/持续而言，文献报道的结果相互矛盾。建议在与患者达成一致后，仔细评估每位患者的临床病史和潜在副作用，再决定是否对成年CCS进行治疗。
