Wassim Chemaitilly, St Jude Children's Research Hospital, Memphis; Jill H. Simmons, Vanderbilt University Medical Center, Nashville, TN; Laurie E. Cohen, Boston Children's Hospital, Boston, MA; Sogol Mostoufi-Moab, University of Pennsylvania, Philadelphia, PA; Briana C. Patterson and Lillian R. Meacham, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA; Hanneke M. van Santen, University Medical Center Utrecht, Utrecht, the Netherlands; and Charles A. Sklar, Memorial Sloan Kettering Cancer Center, New York, NY.
J Clin Oncol. 2018 Jul 20;36(21):2153-2159. doi: 10.1200/JCO.2017.76.3268. Epub 2018 Jun 6.
Endocrine complications are highly prevalent in childhood cancer survivors. Approximately 50% of survivors will experience at least one hormonal disorder over the course of their lives. Endocrine complications often are observed in survivors previously treated with radiation to the head, neck, or pelvis. We provide an overview the most common endocrine late effects seen in survivors, including hypothalamic-pituitary dysfunction, primary thyroid dysfunction, obesity, diabetes mellitus, metabolic syndrome, and decreased bone mineral density. Primary gonadal injury is discussed elsewhere in this series. Given a variable latency interval, a systematic approach where individuals are periodically screened on the basis of their risk factors can help to improve health outcomes by prompt diagnosis and treatment of evolving endocrinopathies. These recommendations must be revised in the future given changes and improvements in cancer treatment over time.
内分泌并发症在儿童癌症幸存者中非常普遍。大约 50%的幸存者在其一生中至少会经历一次激素紊乱。内分泌并发症通常发生在以前接受过头、颈或骨盆放疗的幸存者中。我们提供了在幸存者中最常见的内分泌晚期效应的概述,包括下丘脑-垂体功能障碍、原发性甲状腺功能障碍、肥胖、糖尿病、代谢综合征和骨密度降低。原发性性腺损伤在本系列的其他地方讨论。由于潜伏期不同,基于风险因素定期对个体进行系统筛查的方法可以通过及时诊断和治疗不断发展的内分泌疾病来改善健康结局。鉴于癌症治疗随时间的变化和改进,这些建议将来必须进行修订。