The influence of antineoplastic treatment on the weight of survivors of childhood cancer.
OBJECTIVE
Obesity is a late effect in survivors of childhood cancer and correlates with chronic complications. Survivors of leukemia, brain tumors, and hematopoietic stem cell transplantation are more likely to develop obesity resulting from treatment modalities such as radiotherapy and glucocorticoids. This paper analyzes and integrates the current data available to health professionals in order to clarify strategies that can be used to treat and prevent obesity in childhood cancer survivors.


METHODS
This is a literature review from on scientifically reliable electronic databases. We selected articles published in the last five years and earlier articles of great scientific importance.


RESULTS
The mechanisms involved in the pathophysiology of obesity in cancer survivors are not completely understood, but it is believed that damage to the hypothalamus and endocrine disorders such as insulin resistance, leptin resistance, and hormone deficiency may be involved. The body composition of this group includes a predominance of adipose tissue, especially in those undergoing hematopoietic stem cell transplant and total body irradiation. The use of body mass index in these patients may lead to an underestimation of individuals' risk for metabolic complications.


CONCLUSIONS
Early identification of groups using accurate anthropometric assessments, interventional treatment, and/or preventative measures and counseling is essential to minimize the adverse effects of treatment. Physical activity and healthy eating to promote adequacy of weight in the whole population should be encouraged.
Universidade Federal de São Paulo (UNIFESP), Programa de Pós-graduação em Alimentos, Nutrição e Saúde, Santos, SP, Brazil.
Julia Ferrari Carneiro
JF
Teixeira
Instituto de Oncologia Pediátrica/Grupo de Apoio ao Adolescente e à Criança com Câncer (IOP/GRAACC), São Paulo, SP, Brazil.
Priscila Dos Santos
PD
Maia-Lemos
Instituto de Oncologia Pediátrica/Grupo de Apoio ao Adolescente e à Criança com Câncer (IOP/GRAACC), São Paulo, SP, Brazil.
Mônica Dos Santos
MD
Cypriano
Universidade Federal de São Paulo (UNIFESP), Departamento de Biociências, Santos, SP, Brazil. Electronic address: lucianapisani@gmail.com.
Luciana Pellegrini
LP
Pisani
D016543:Central Nervous System Neoplasms / Q000628:therapy*; D002648:Child; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D009369:Neoplasms / Q000628:therapy; D063766:Pediatric Obesity / Q000209:etiology* / Q000517:prevention & control; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D017741:Survivors
Bone marrow transplantation; Child; Criança; Neoplasias; Neoplasms; Obesidade; Obesity; Radioterapia; Radiotherapy; Sobreviventes; Survivors; Transplante de Medula Óssea