title: [Endocrine sequelae after treatment of pediatric cancer: From childhood to adulthood].
abstract: Endocrine sequelae are among the most frequently reported complications in childhood cancer survivors, affecting 40 to 60% of these patients during adult life. Most of these complications are the result of cranial radiation therapy for brain or facial tumor, lymphoma or leukemia. The present review describes the main endocrine disturbances observed in this population, including disorders of hypothalamic-pituitary axis, especially the frequently observed growth hormone deficiency and disorders of puberty, thyroid and parathyroid dysfunction, obesity and metabolic syndrome, alterations in glucose metabolism and decreased bone mineral density. Gonadal dysfunction is not described, since it is detailed in another chapter. During childhood, prompt diagnosis and management of endocrine complications allow improvement of final height outcome and body composition (lean body mass and bone mass), reducing morbidity and impaired quality of life later in adulthood. Risk of developing a second neoplasm after growth hormone therapy in cancer survivors is also addressed. Life-long follow-up and management of endocrine deficiencies are essential to reduce late morbidity especially cardiovascular risk, and to diagnose late-onset deficiencies as well as radiation-induced thyroid nodules and cancer.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, hôpitaux Paris-Sud, service d'endocrinologie pédiatrique, site Bicêtre, 94270 Le Kremlin-Bicêtre, France; Centre d'épidémiologie et santé des populations, épidémiologie des radiations, Inserm U1018 équipe 3, Gustave-Roussy B2M, 94805 Villejuif, France. Electronic address: cecile.teinturier@bct.aphp.fr.
authors.forename: Cécile
authors.initials: C
authors.lastname: Thomas-Teinturier
authors.affiliation: Assistance Publique-Hôpitaux de Paris, hôpitaux Paris-Sud, service d'endocrinologie, site Bicêtre, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Salenave
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001932:Brain Neoplasms / Q000532:radiotherapy; D002318:Cardiovascular Diseases / Q000209:etiology; D002648:Child; D003920:Diabetes Mellitus / Q000209:etiology; D004700:Endocrine System Diseases / Q000209:etiology* / Q000628:therapy; D005260:Female; D005640:Follicle Stimulating Hormone / Q000172:deficiency; D013006:Growth Hormone / Q000172:deficiency / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000528:radiation effects; D007986:Luteinizing Hormone / Q000172:deficiency; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology; D009369:Neoplasms / Q000532:radiotherapy*; D010024:Osteoporosis / Q000209:etiology; D011629:Puberty, Precocious / Q000209:etiology; D012307:Risk Factors; D017741:Survivors; D013959:Thyroid Diseases / Q000209:etiology; D013961:Thyroid Gland / Q000528:radiation effects
chemical_list: D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013006:Growth Hormone
keywords: Cancer de l’enfant; Childhood cancer; Déficit en hormone de croissance; Endocrine sequelae; Growth hormone deficiency; Growth hormone therapy; Hormone de croissance; Long-term follow-up; Radiotherapy; Radiothérapie; Suivi à long terme; Séquelles endocriniennes