Childhood Cancer Treatments and Associated Endocrine Late Effects: A Concise Guide for the Pediatric Endocrinologist

Abstract

Endocrine complications are frequently observed in childhood cancer survivors (CCS); in many instances, these complications develop months to years after the completion of cancer therapy. The estimated prevalence of endocrine late effects is 50% among CCS; the main risk factors are external beam radiation that includes key endocrine organs (the hypothalamus/pituitary, thyroid and gonads) and/or alkylating agents. Novel agents targeting tumor growth have increased the options available to a small number of patients albeit with the need for treatment over long periods of time. Some of these agents, such as certain tyrosine kinase inhibitors and immune system modulators have been shown to cause permanent endocrine deficits. This chapter offers a brief summary of the conventional treatment strategies for the most common cancers of childhood and a brief overview of the endocrine late effects most commonly associated with these exposures. The impact of targeted therapies on the endocrine system will also be discussed. The aim of this chapter is to provide basic guidance to the consulting pediatric endocrinologist in preparation for the clinical encounter with a CCS. A more detailed discussion of the management of specific endocrine late effects can be found in the other chapters in this series.

A nationwide questionnaire survey targeting Japanese pediatric endocrinologists regarding transitional care in childhood, adolescent, and young adult cancer survivors

“…The Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, issued by the Children's Oncology Group, are recognized as very useful resources for healthcare providers (7). Endocrine abnormalities were reported in more than 50% of CCS (8)(9)(10)(11)(12). Therefore, the CCS Committee of the Japanese Society for Pediatric Endocrinology (JSPE) issued a follow-up guide regarding CCS care (13).…”

Continuous treatment with cisplatin induces the oocyte death of primordial follicles without activation

“…1 These complications often appear in childhood cancer survivors (CCSs) months to years after treatment. 2,3 Monitoring complications in CCSs and studying off-target effects of cancer therapy are critical for improving the quality of life.…”

Possible Mechanisms of Subsequent Neoplasia Development in Childhood Cancer Survivors: A Review

“…Severe toxicity in Ewing s sarcoma patients treated in the Euro-EWING99-R1 trial was more common in women than in men, regardless of toxicity type [26]. Hormonal influences may also contribute to this difference, because the prevalence of endocrine late effects had about half of CCSs [27]. Nevertheless, the cause of the higher incidence of SMN in women has not yet been fully elucidated.…”