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Minerva Endocrinologica 2016 March;41(1):78-104

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Late endocrine effects of cancer and cancer therapies in survivors of childhood malignancies

Pedro MARQUES ¹, Hans VAN HUELLEN ², Ailbhe FITZPATRICK ², Maralyn DRUCE ² ✉

¹ Endocrinology Department, Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal; ² Department of Endocrinology, St. Bartholomew’s Hospital, London, UK

The development of several cancer treatment modalities including surgery, radiotherapy and chemotherapy has improved the survival rates of childhood cancers over recent decades, leading to an increase in the population of childhood cancer survivors. Detailed epidemiological studies have demonstrated that childhood cancer survivors frequently develop medical complications months or years after cancer treatment. Endocrine complications are common in survivors, particularly those exposed to radiotherapy, total body irradiation and alkylating agents, and may involve dysfunction of the hypothalamic-pituitary axes, gonads, thyroid gland, bone and body composition as well as metabolic abnormalities. Early identification and proper management of these disorders can significantly improve the quality of life and reduce the morbidity and potentially mortality in this population. Multidisciplinary teams, expert physicians and the development of healthcare structures are key elements for improving the screening, surveillance, cost effectiveness and overall management of endocrine late effects of cancer therapies in childhood cancer survivors. The aim of the present review was to discuss the most important and common late endocrine effects of childhood cancer treatment.