title: [Long-term endocrine complications after brain tumor treatment--own experience].
abstract: BACKGROUND
  Long-term endocrine complications affect approximately 40% of childhood cancer survivors.
  
  
  OBJECTIVE
  The retrospective analysis of parameters of the endocrine system function up to 10 years after head radiotherapy (RT) and chemotherapy (CT) due to malignant solid tumor of the central nervous system.
  
  
  METHODS
  The analysis included 30 patients (15 girls; 15 boys) followed in Endocrine Outpatient Department, University Children's Hospital of Krakow for 1-10 years (mean 5.8 years) after completion of cancer therapy.
  
  
  RESULTS
  There was no endocrinopathy in 11 patients (34%), but only five of them were followed for longer than 5 years. A single endocrine disorder was seen in patients (28%), two independent disorders in six (20%), three in three children (10%), and four in two (6.7%). The most common endocrine disorder was growth hormone deficiency (GHD) (13 patients, 46.6%). Primary and secondary hypothyroidism were observed in seven (23%) and two patients (6.7%), respectively, secondary adrenal insufficiency in two (6.7%), hypogonadotropic or hypergonadotropic hypogonadism in seven (23%) and two patients (6.7%), respectively. Obesity without any hormone deficiency was present in five patients (16.6%) patients, in one case, the condition was complicated by glucose intolerance, in four children, by a high level of triglycerides and low HDL cholesterol.
  
  
  CONCLUSIONS
  1. Late endocrine complications after malignant brain tumor treatment affect 66% of patients followed for 1-10 years after completion of RT. That points to the necessity of long-term, regular followup of the patients after cancer treatment. 2. The most common endocrinopathy is GHD, followed by hypothyroidism, hypogonadism and adrenal insufficiency. 3. In patients after head RT and CT in childhood, there is noted secondary obesity, with complications typical for metabolic syndrome.
authors: Klinika Endokrynologii Dzieci i Młodziezy, Katedry Pediatrii, Polsko-Amerykański Instytut Pediatrii, Uniwersytet Jagielloński, Collegium Medicum, Kraków. malgorzata.wojcik@uj.edu.pl
authors: Małgorzata
authors: M
authors: Wójcik
authors: Katarzyna
authors: K
authors: Dolezal-Ołtarzewska
authors: Małgorzata
authors: M
authors: Kumorowicz-Czoch
authors: Anna
authors: A
authors: Kalicka-Kasperczyk
authors: Dominika
authors: D
authors: Januś
authors: Agata
authors: A
authors: Zygmunt-Górska
authors: Joanna
authors: J
authors: Wojtyś
authors: Elzbieta
authors: E
authors: Korab-Chrzanowska
authors: Stanisław
authors: S
authors: Kwiatkowski
authors: Jerzy
authors: J
authors: Starzyk
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000209:etiology; D004700:Endocrine System Diseases / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology; D011832:Radiation Injuries / Q000150:complications*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D019382:Human Growth Hormone