Memorial Sloan-Kettering Cancer Center, New York, New York.
Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York.
J Clin Endocrinol Metab. 2018 Aug 1;103(8):2761-2784. doi: 10.1210/jc.2018-01175.
To formulate clinical practice guidelines for the endocrine treatment of hypothalamic-pituitary and growth disorders in survivors of childhood cancer.
An Endocrine Society-appointed guideline writing committee of six medical experts and a methodologist.
Due to remarkable improvements in childhood cancer treatment and supportive care during the past several decades, 5-year survival rates for childhood cancer currently are >80%. However, by virtue of their disease and its treatments, childhood cancer survivors are at increased risk for a wide range of serious health conditions, including disorders of the endocrine system. Recent data indicate that 40% to 50% of survivors will develop an endocrine disorder during their lifetime. Risk factors for endocrine complications include both host (e.g., age, sex) and treatment factors (e.g., radiation). Radiation exposure to key endocrine organs (e.g., hypothalamus, pituitary, thyroid, and gonads) places cancer survivors at the highest risk of developing an endocrine abnormality over time; these endocrinopathies can develop decades following cancer treatment, underscoring the importance of lifelong surveillance. The following guideline addresses the diagnosis and treatment of hypothalamic-pituitary and growth disorders commonly encountered in childhood cancer survivors.
制定儿童癌症幸存者下丘脑-垂体和生长障碍内分泌治疗的临床实践指南。
内分泌学会任命的 6 名医学专家和方法学家组成的指南写作委员会。
由于过去几十年中儿童癌症治疗和支持性护理的显著改善，目前儿童癌症的 5 年生存率>80%。然而，由于疾病及其治疗，儿童癌症幸存者面临多种严重健康状况的风险增加，包括内分泌系统疾病。最近的数据表明，40%至 50%的幸存者在其一生中会发展出内分泌紊乱。内分泌并发症的危险因素包括宿主（例如，年龄、性别）和治疗因素（例如，辐射）。辐射暴露于关键的内分泌器官（例如，下丘脑、垂体、甲状腺和性腺）使癌症幸存者随着时间的推移面临发生内分泌异常的最高风险；这些内分泌疾病可以在癌症治疗后几十年发生，强调了终身监测的重要性。本指南针对儿童癌症幸存者中常见的下丘脑-垂体和生长障碍的诊断和治疗。
