Changes in body composition after childhood cancer treatment: impact on future health status--a review.
OBJECTIVE
To describe data on changes in body composition in childhood cancer survivors. Underlying mechanisms in development of obesity are addressed, in order to discuss intervention strategies.


METHODS
A systematic literature search was undertaken with a number of search terms.


RESULTS
Female survivors of ALL and brain tumours, especially if treated with cranial irradiation, showed a higher prevalence of obesity compared with the general population, while survivors of other malignancies had a higher prevalence of underweight. Influences of corticosteroid treatment and cytostatics on body composition are uncertain. Diminished physical activity, early adiposity rebound (<5 years of age) and/or hypothalamic involvement of tumour or treatment, and subsequent growth hormone deficiency, may play a role in the development of obesity in childhood cancer survivors.


CONCLUSIONS
Longitudinal prospective studies in more extensive cohorts are necessary to estimate actual prevalence and facilitate the unravelling of the underlying mechanisms in change of body composition.
Brouwer
C A J
CA
Department of Paediatrics, Subdivision Paediatric Oncology, University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands. c.a.j.brouer@bkk.umcg.nl
Gietema
J A
JA
Kamps
W A
WA
de Vries
E G E
EG
Postma
A
A
D001823:Body Composition; D015992:Body Mass Index; D001932:Brain Neoplasms / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016371:Cranial Irradiation / Q000009:adverse effects; D013006:Growth Hormone / Q000172:deficiency; D006304:Health Status; D006801:Humans; D020738:Leptin / Q000378:metabolism; D008137:Longitudinal Studies; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D011110:Polymorphism, Genetic; D015995:Prevalence
D020738:Leptin; D013006:Growth Hormone