The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours.
Affiliation
Department of Endocrinology, Christie Hospital, Manchester M20 4BX, UK. Helena.Gleeson@christie-tr.nwest.nhs.ukIssue Date
2004-12
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Survival rates are improving following cancer therapy for childhood brain tumours. There is therefore a growing cohort of survivors at risk of late effects of cancer therapy. Endocrine problems are very common in these patients. The recognition and prompt management of these are essential to prevent further morbidity and impairment of quality of life. Cranial radiation can damage hypothalamic-pituitary function, most frequently affecting GH status; however, higher radiation doses may cause more widespread hypothalamic-pituitary damage. Early puberty secondary to cranial irradiation is now being managed with gonadotrophin-releasing hormone analogues to improve final height. Prompt diagnosis and management of GH deficiency may improve final height outcome; continued GH therapy beyond final height aids the achievement of adult body composition (lean body mass and bone mass) and GH therapy in adulthood improves quality of life. Both cranial irradiation alone and with spinal irradiation can result in radiation damage to the thyroid resulting in hypothyroidism and thyroid nodules, a high proportion of which are malignant. Gonadal damage secondary to spinal irradiation and adjuvant chemotherapy may have long-term consequences including infertility.Citation
The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours. 2004, 11 (4):589-602 Endocr. Relat. CancerJournal
Endocrine-Related CancerDOI
10.1677/erc.1.00779PubMed ID
15613441Type
ArticleLanguage
enISSN
1351-0088ae974a485f413a2113503eed53cd6c53
10.1677/erc.1.00779
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