Hypothalamic-Pituitary and Other Endocrine Surveillance Among Childhood Cancer Survivors.

Document Type

Article

Publication Date

9-26-2022

Identifier

DOI: 10.1210/endrev/bnab040

Abstract

Endocrine disorders in survivors of childhood, adolescent, and young adult (CAYA) cancers are associated with substantial adverse physical and psychosocial effects. To improve appropriate and timely endocrine screening and referral to a specialist, the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) aims to develop evidence and expert consensus-based guidelines for healthcare providers that harmonize recommendations for surveillance of endocrine disorders in CAYA cancer survivors. Existing IGHG surveillance recommendations for premature ovarian insufficiency, gonadotoxicity in males, fertility preservation, and thyroid cancer are summarized. For hypothalamic-pituitary (HP) dysfunction, new surveillance recommendations were formulated by a guideline panel consisting of 42 interdisciplinary international experts. A systematic literature search was performed in MEDLINE (through PubMed) for clinically relevant questions concerning HP dysfunction. Literature was screened for eligibility. Recommendations were formulated by drawing conclusions from quality assessment of all evidence, considering the potential benefits of early detection and appropriate management. Healthcare providers should be aware that CAYA cancer survivors have an increased risk for endocrine disorders, including HP dysfunction. Regular surveillance with clinical history, anthropomorphic measures, physical examination, and laboratory measurements is recommended in at-risk survivors. When endocrine disorders are suspected, healthcare providers should proceed with timely referrals to specialized services. These international evidence-based recommendations for surveillance of endocrine disorders in CAYA cancer survivors inform healthcare providers and highlight the need for long-term endocrine follow-up care in subgroups of survivors and elucidate opportunities for further research.

Journal Title

Endocrine reviews

Volume

43

Issue

5

First Page

794

Last Page

823

MeSH Keywords

Adolescent; Cancer Survivors; Child; Endocrine System Diseases; Female; Humans; Hypothalamic Diseases; Male; Neoplasms; Pituitary Diseases; Survivors; Thyroid Neoplasms; Young Adult

Keywords

childhood cancer survivor; clinical practice guidelines; endocrine complications; endocrine late effects; radiotherapy late effects

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