Hypothalamic-Pituitary and Other Endocrine Surveillance Among Childhood Cancer Survivors.
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van Iersel Laura, Mulder Renee L, Denzer Christian, Cohen Laurie E, Spoudeas Helen A, Meacham Lillian R, Sugden Elaine, Schouten-van Meeteren Antoinette Y N, Hoving Eelco W, Packer Roger J, Armstrong Gregory T, Mostoufi-Moab Sogol, Stades Aline M, van Vuurden Dannis, Janssens Geert O, Thomas-Teinturier Cécile, Murray Robert D, Di Iorgi Natascia, Neggers Sebastian J C M M, Thompson Joel, Toogood Andrew A, Gleeson Helena, Follin Cecilia, Bardi Edit, Torno Lilibeth, Patterson Briana, Morsellino Vera, Sommer Grit, Clement Sarah C, Srivastava Deokumar, Kiserud Cecilie E, Fernandez Alberto, Scheinemann Katrin, Raman Sripriya, Yuen Kevin C J, Wallace W Hamish, Constine Louis S, Skinner Roderick, Hudson Melissa M, Kremer Leontien C M, Chemaitilly Wassim, van Santen Hanneke M
Аннотация
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.