Endocrine Health Problems Detected in 519 Patients Evaluated in a Pediatric Cancer Survivor Program
Endocrine Health Problems Detected in 519 Patients Evaluated in a Pediatric Cancer Survivor Program
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DOI：
10.1210/jc.2011-2104
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发表时间：
2012-03-01
影响因子：
5.8
通讯作者：
Meacham, Lillian
中科院分区：
文献类型：
--
作者：
Patterson, Briana C.;Wasilewski-Masker, Karen;Meacham, Lillian
背景：许多儿童癌症幸存者患有内分泌疾病。国家指南建议对迟发效应进行监测。建议在使用烷化剂、类固醇、甲氨蝶呤和放射治疗后进行内分泌监测。目的：该研究的目的是描述在使用国家筛查指南的计划中随访的患者的内分泌结果。设计：该研究的设计是病历审查。背景：该研究是在综合癌症幸存者计划（一项学术儿科肿瘤学计划）中进行的。参与者：该研究包括 519 名非中枢神经系统童年的儿童和年轻成人幸存者2001年1月1日至2005年12月15日之间的恶性肿瘤。干预：根据病史、体检和儿童肿瘤学组儿童、青少年和青年癌症幸存者长期随访指南中推荐的评估对患者进行评估。结果测量：测量内分泌状况的频率和类型。结果：在299名幸存者中观察到480种内分泌状况（57.6% 的幸存者）。最常见的内分泌疾病类型是体重和性腺功能问题。在 Cox 回归模型中，干细胞移植、放射治疗和癌症诊断年龄较大与内分泌疾病的较高风险相关。放射、干细胞移植和肉瘤诊断与生长问题有关。结论：内分泌失调在儿童癌症之后很常见。内分泌科医生应了解国家指南，预期儿科癌症幸存者的转诊，并参与进一步的研究，以优化癌症治疗内分泌效应的筛查和治疗。 (临床内分泌代谢杂志 97: 810-818, 2012)
Context: Many pediatric cancer survivors have endocrine conditions. Surveillance for late effects is recommended by national guidelines. Endocrine surveillance is recommended after alkylating agents, steroids, methotrexate, and radiation.Objective: The objective of the study was to describe the endocrine outcomes in patients followed up in a program that uses national screening guidelines.Design: The design of the study was a medical records review.Setting: The study was conducted in the Comprehensive Cancer Survivor Program, an academic pediatric oncology program.Participants: The study included 519 pediatric and young adult survivors of noncentral nervous system childhood malignancies between January 1, 2001, and December 15, 2005.Intervention: Patients were evaluated with history, physical examinations, and evaluations recommended in the Children's Oncology Group's Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers.Outcome Measures: The frequency and types of endocrine conditions were measured.Results: Four hundred eighty endocrine conditions were observed in 299 survivors (57.6% of survivors). The most common types of endocrine conditions were problems with weight and gonadal function. In a Cox regression model, stem cell transplant, radiation, and older age at cancer diagnosis were associated with higher hazard of an endocrine condition. Radiation, stem cell transplant, and sarcoma diagnosis were associated with growth problems.Conclusions: Endocrine disorders were common after pediatric cancers. Endocrinologists should be aware of national guidelines, anticipate referral of pediatric cancer survivors, and participate in further research to optimize screening for and treatment of endocrine effects of cancer therapy. (J Clin Endocrinol Metab 97: 810-818, 2012)